Provider Demographics
NPI:1730252842
Name:VANDERHOOF, AARON (RDO)
Entity type:Individual
Prefix:MR
First Name:AARON
Middle Name:
Last Name:VANDERHOOF
Suffix:
Gender:M
Credentials:RDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 WALNUT STREET EXT
Mailing Address - Street 2:
Mailing Address - City:AGAWAM
Mailing Address - State:MA
Mailing Address - Zip Code:01001-1524
Mailing Address - Country:US
Mailing Address - Phone:413-786-0719
Mailing Address - Fax:
Practice Address - Street 1:338 WALNUT STREET EXT
Practice Address - Street 2:
Practice Address - City:AGAWAM
Practice Address - State:MA
Practice Address - Zip Code:01001-1524
Practice Address - Country:US
Practice Address - Phone:413-786-0719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5216156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician