Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1083764716 |
---|---|
Provider Name | Mr. Charles John Aldinger |
First Address | Rochester, NY 14624-1367 |
Second Address | Rochester, NY 14618-5620 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2007 |
Last Update Date | 22/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1245467711 | NPI (01) | NY |