Provider Demographics
NPI:1386761278
Name:ALDI, DEAN (RPH)
Entity type:Individual
Prefix:
First Name:DEAN
Middle Name:
Last Name:ALDI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HERKIMER
Mailing Address - State:NY
Mailing Address - Zip Code:13350-2300
Mailing Address - Country:US
Mailing Address - Phone:315-866-8255
Mailing Address - Fax:315-866-3610
Practice Address - Street 1:200 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HERKIMER
Practice Address - State:NY
Practice Address - Zip Code:13350-2300
Practice Address - Country:US
Practice Address - Phone:315-866-8255
Practice Address - Fax:315-866-3610
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031162183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist