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General NPI Number Information
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NPI Number | 1629026919
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Entity Type | Individual
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Provider Name | JOSEPH JOHN DALLESSIO MD
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Gender | Male
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 300 2ND AVE FL 3
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City | LONG BRANCH
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State | NJ
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Zip | 07740-6303
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Country | US
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Telephone | 732-923-7250
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Fax |
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Provider Business Mailing Address
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Address Line | 379 CAMPUS DR FL 4
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City | SOMERSET
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State | NJ
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Zip | 08873-1161
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Country | US
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Telephone | 732-937-8939
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 036112755
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 25MA06236100
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | ME59520
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 25942
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License Number State | AL
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Taxonomy #5
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 01061908A
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License Number State | IN
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Taxonomy #6
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | MD38247
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License Number State | TN
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Taxonomy #7
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 10858
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License Number State | NV
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