Basic Information
| Provider Information | |||||||||
| NPI: | 1710982897 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALDEA | ||||||||
| FirstName: | ERLINDA | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 457 | ||||||||
| Address2: | 5 E ALVON ROAD, SUITE 7 | ||||||||
| City: | WHITE SULPHUR SPRINGS | ||||||||
| State: | WV | ||||||||
| PostalCode: | 249862373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3045365030 | ||||||||
| FaxNumber: | 3045365031 | ||||||||
| Practice Location | |||||||||
| Address1: | 2501 VALLEY RIDGE RD | ||||||||
| Address2: | |||||||||
| City: | COVINGTON | ||||||||
| State: | VA | ||||||||
| PostalCode: | 244266339 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5408624146 | ||||||||
| FaxNumber: | 5408620131 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2005 | ||||||||
| LastUpdateDate: | 10/15/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 0101021985 | VA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 006717357 | 05 | VA | MEDICAID | 0112608000 | 05 | WV | MEDICAID |