Provider Demographics
NPI:1568047413
Name:DILEO, ALEXA CATHLEEN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:CATHLEEN
Last Name:DILEO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 HENRY LN
Mailing Address - Street 2:
Mailing Address - City:HIGGANUM
Mailing Address - State:CT
Mailing Address - Zip Code:06441-4433
Mailing Address - Country:US
Mailing Address - Phone:203-915-9707
Mailing Address - Fax:
Practice Address - Street 1:628 CONGDON ST W
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-7939
Practice Address - Country:US
Practice Address - Phone:203-915-9707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12778208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation