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Contact Information

PATRICK M DALESSIO, PA-C
516 EAST NIZHONI BLVD.
GALLUP, NM87301-1337
 Phone: 505-722-1000
 Fax: 505-726-8671
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
 

Physician Assistant

363A00000X 97 Physician Assistant
 

Surgical

363AS0400X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for PATRICK M DALESSIO · (Male)

NPI # 1699782102
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 08/01/2006
Last updated 07/18/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • WA License # PA10004407
  • WA Medicaid 8354375
  • WA Other 0197285 L&I PIN
  • WA Other 06173U REGENCE BLUE SHIELD PIN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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