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General NPI Number Information
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NPI Number | 1346436417
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Entity Type | Individual
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Provider Name | NANETTE ALDAHONDO MD
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Gender | Female
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 09/17/2012
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Provider Practice Location Address
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Address Line | 200 UNIVERSITY AVE E GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
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City | SAINT PAUL
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State | MN
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Zip | 55101-2507
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Country | US
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Telephone | 651-325-2317
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Fax |
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Provider Business Mailing Address
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Address Line | 200 UNIVERSITY AVE E GILLETTE CHILDREN'S SPECIALTY HEALTHCARE
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City | SAINT PAUL
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State | MN
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Zip | 55101-2507
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P0010X
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Taxonomy Name | Pediatric Rehabilitation Medicine Physician
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License Number | 55538
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License Number State | MN
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