Healthcare Provider Details

I. General information

NPI: 1205786209
Provider Name (Legal Business Name): ALYSSA DALEO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 OLD COUNTRY RD STE 16
RIVERHEAD NY
11901-2148
US

IV. Provider business mailing address

660 WHITE PLAINS RD FL 4
TARRYTOWN NY
10591-5187
US

V. Phone/Fax

Practice location:
  • Phone: 631-727-8050
  • Fax:
Mailing address:
  • Phone: 914-984-2552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: