Individual
MR. EDWARD THOMAS MOLDENHAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH (MS BPHARM)
Contact information
Practice address
ROUTE 12 BLDG 449, NAVAL AMBULATORY CARE CENTER ATTN PROFESSIONAL AFFAIRS, GROTON, CT 06349-5600
(860) 694-2377
(860) 694-2590
Mailing address
1 ANNIE GEORGE DR, PO BOX 3559, MASHANTUCKET, CT 06338-3559
(860) 396-2058
(860) 396-6212
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
28RI02090700
NJ
Other
Enumeration date
11/23/2005
Last updated
03/03/2010
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