Provider Demographics
NPI:1629409545
Name:DALESSANDRO, DIANE (RN)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:DALESSANDRO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25
Mailing Address - Street 2:
Mailing Address - City:MELLENVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12544-0025
Mailing Address - Country:US
Mailing Address - Phone:518-253-7263
Mailing Address - Fax:
Practice Address - Street 1:663 ROUTE 217
Practice Address - Street 2:
Practice Address - City:MELLENVILLE
Practice Address - State:NY
Practice Address - Zip Code:12544
Practice Address - Country:US
Practice Address - Phone:518-253-7263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-02
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338613-1163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health