Provider Demographics
NPI:1619067642
Name:ALDI, MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:ALDI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:662 GOFFLE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-3420
Mailing Address - Country:US
Mailing Address - Phone:973-427-3200
Mailing Address - Fax:973-427-2399
Practice Address - Street 1:662 GOFFLE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:HAWTHORNE
Practice Address - State:NJ
Practice Address - Zip Code:07506-3420
Practice Address - Country:US
Practice Address - Phone:973-427-3200
Practice Address - Fax:973-427-2399
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC05688111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP-2175992OtherOXFORD
NJ7810160OtherAETNA
NJ7810160OtherAETNA