Provider Demographics
NPI:1356534184
Name:FREDA, ALDO A (DMD)
Entity type:Individual
Prefix:DR
First Name:ALDO
Middle Name:A
Last Name:FREDA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5054
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-0054
Mailing Address - Country:US
Mailing Address - Phone:908-859-8306
Mailing Address - Fax:
Practice Address - Street 1:1630 ROUTE 31
Practice Address - Street 2:STATE RT 31
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809
Practice Address - Country:US
Practice Address - Phone:908-730-8880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDIO12283122300000X
NJDI012283122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist