Annette Louise Dalezman

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

019422 Issued in NY

Practice address

3415 Bainbridge Ave
Bronx, NY 10467-2403

Phone

(718) 741-2631

NPI assigned

Jan 9, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: adalezma@montefioredirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Montefiore Medical Center

  • Anesthesiology Physician
  • Bronx, NY
  • NPI 1063525152
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1452297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483142400000",
    "number": "1174989925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672403",
            "telephone_number": "718-741-2631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 BAINBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672403",
            "telephone_number": "718-741-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALEZMAN",
        "first_name": "ANNETTE",
        "middle_name": "LOUISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-09",
        "last_updated": "2016-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "019422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shackira Daley
• Sherine J Daley
• Teina Corine Daley, OTR/L, OTD, CHT
• Teshna A Daley, LPN
• Thomas Daley, MD
• Emad Eddin Dalla
• Linda Elena Dallam, NP
• Linda J Dalland, RNP
• Marise Dalmacy
• Sheneka Dalmage, NP

• Physician Assistant in Bronx, NY
• Providers in Bronx, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.