MEDICARE: ALYSSA DALEO PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant		NY

General Provider Information

NPI Number	:	1205786209
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA DALEO PA-C

Provider Business Mailing Address
First Line	:	660 WHITE PLAINS RD FL 4
Second Line	:
City	:	TARRYTOWN
State	:	NY
Zip	:	10591-5187
Country	:	US
Telephone Number	:	914-984-2552
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 OLD COUNTRY RD STE 16
Second Line	:
City	:	RIVERHEAD
State	:	NY
Zip	:	11901-2148
Country	:	US
Telephone Number	:	631-727-8050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/29/2026
Last Update Date	:	04/20/2026

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Directions to “ ALYSSA DALEO PA-C” Practice Location

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