Healthcare Provider Details

I. General information

NPI: 1851014153
Provider Name (Legal Business Name): HALEY ALYSE CABASSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 SUNRISE HWY
WEST ISLIP NY
11795-2110
US

IV. Provider business mailing address

325 SUNRISE HWY
WEST ISLIP NY
11795-2110
US

V. Phone/Fax

Practice location:
  • Phone: 631-594-9390
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number123062
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: