Provider Demographics
NPI:1770870040
Name:HEALEY, ALEEYA (MD)
Entity type:Individual
Prefix:DR
First Name:ALEEYA
Middle Name:
Last Name:HEALEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALEEYA
Other - Middle Name:
Other - Last Name:MOHAMMED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:255 PATROON CREEK BLVD APT 4475
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-5054
Mailing Address - Country:US
Mailing Address - Phone:973-405-1528
Mailing Address - Fax:
Practice Address - Street 1:391 MYRTLE AVE STE 3B
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3835
Practice Address - Country:US
Practice Address - Phone:518-264-5401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2771992080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral PediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04020311Medicaid