Provider Demographics
NPI:1396830675
Name:DALEO, JOSEPH M (RPA-C)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:M
Last Name:DALEO
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 MIDDLE COUNTRY RD
Mailing Address - Street 2:
Mailing Address - City:SELDEN
Mailing Address - State:NY
Mailing Address - Zip Code:11784-2545
Mailing Address - Country:US
Mailing Address - Phone:631-732-4300
Mailing Address - Fax:631-732-4392
Practice Address - Street 1:325 MIDDLE COUNTRY RD
Practice Address - Street 2:
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-2545
Practice Address - Country:US
Practice Address - Phone:631-732-4300
Practice Address - Fax:631-732-4392
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009055363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical