Provider Demographics
NPI:1437334968
Name:DAVID J. AIDONE
Entity Type:Organization
Organization Name:DAVID J. AIDONE
Other - Org Name:AIDONE EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPTICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:AIDONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-234-2020
Mailing Address - Street 1:980 E MAIN ST
Mailing Address - Street 2:SIUTE 4
Mailing Address - City:COBLESKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12043-5742
Mailing Address - Country:US
Mailing Address - Phone:518-234-2020
Mailing Address - Fax:
Practice Address - Street 1:980 E MAIN ST
Practice Address - Street 2:SIUTE 4
Practice Address - City:COBLESKILL
Practice Address - State:NY
Practice Address - Zip Code:12043-5742
Practice Address - Country:US
Practice Address - Phone:518-234-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-03
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
006746-1332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
000496936001OtherBS OF NENY
112656OtherBC/BS OF UTICA-WATERTOWN
112656OtherBC/BS OF UTICA-WATERTOWN