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Individual

COLLEEN M DIBBLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
624 MCCLELLAN ST, SUITE G02, SCHENECTADY, NY 12304-1020
(518) 382-2203
(518) 382-2226
Mailing address
624 MCCLELLAN ST, SUITE G02, SCHENECTADY, NY 12304-1020
(518) 382-2203
(518) 382-2226

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
263695
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03561199
NY
01
130603000000
FIDELIS
NY
01
7367465
AETNA
NY
01
755CJ1
EMPIRE BLUECROSS/BLUESHIELD
NY
Enumeration date
06/24/2006
Last updated
05/06/2016
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