Provider Demographics
NPI:1518080175
Name:DALESSIO, LINDA (APRN)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:DALESSIO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 WOLCOTT RD
Mailing Address - Street 2:
Mailing Address - City:WOLCOTT
Mailing Address - State:CT
Mailing Address - Zip Code:06716-2641
Mailing Address - Country:US
Mailing Address - Phone:203-879-5504
Mailing Address - Fax:203-879-5504
Practice Address - Street 1:246 WOLCOTT RD
Practice Address - Street 2:
Practice Address - City:WOLCOTT
Practice Address - State:CT
Practice Address - Zip Code:06716-2641
Practice Address - Country:US
Practice Address - Phone:203-879-5504
Practice Address - Fax:203-879-5504
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003402363LC0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTLICOther003402