Provider Demographics
NPI:1336430131
Name:ALDEN, JOHN HYDE JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:HYDE
Last Name:ALDEN
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:101 ROBINHOOD LN
Mailing Address - Street 2:
Mailing Address - City:CAMILLUS
Mailing Address - State:NY
Mailing Address - Zip Code:13031-2310
Mailing Address - Country:US
Mailing Address - Phone:315-387-5701
Mailing Address - Fax:315-435-5540
Practice Address - Street 1:101 ROBINHOOD LN
Practice Address - Street 2:
Practice Address - City:CAMILLUS
Practice Address - State:NY
Practice Address - Zip Code:13031-2310
Practice Address - Country:US
Practice Address - Phone:315-387-5701
Practice Address - Fax:315-435-5540
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY006400363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical