Provider Demographics
NPI:1972955870
Name:ALDAPE, ERIN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:ALDAPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 S 8TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-7136
Mailing Address - Country:US
Mailing Address - Phone:208-734-4139
Mailing Address - Fax:208-344-1391
Practice Address - Street 1:409 S 8TH ST STE 101
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-7136
Practice Address - Country:US
Practice Address - Phone:208-734-4139
Practice Address - Fax:208-344-1391
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician