Edward Thomas Moldenhauer, RPH (MS BPHARM)

Primary specialty

Pharmacotherapy PharmacistTaxonomy code 1835P1200X

License

28RI02090700 Issued in NJ

Practice address

Route 12 BLDG 449
Naval Ambulatory Care Center Attn Professional Affairs
Groton, CT 06349-5600

Phone

(860) 694-2377

Fax

(860) 694-2590

NPI assigned

Nov 23, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mr. Edward Thomas Moldenhauer Jr. Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1992788962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ANNIE GEORGE DR",
            "address_2": "PO BOX 3559",
            "city": "MASHANTUCKET",
            "state": "CT",
            "postal_code": "063383559",
            "telephone_number": "860-396-2058",
            "fax_number": "860-396-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ROUTE 12 BLDG 449",
            "address_2": "NAVAL AMBULATORY CARE CENTER ATTN PROFESSIONAL AFFAIRS",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063495600",
            "telephone_number": "860-694-2377",
            "fax_number": "860-694-2590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLDENHAUER",
        "first_name": "EDWARD",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "RPH (MS BPHARM)",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "NJ",
            "license": "28RI02090700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EDWARD",
            "last_name": "MOLDENHAUER",
            "middle_name": "THOMAS",
            "prefix": "MR.",
            "suffix": "JR.",
            "credential": "RPH (MS BPHARM)",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Matthew Braden Burns Miller, DDS
• Renay Miller, BSC(PHARMACY)
• Dawn Mingione, M.S. CCC-SLP
• Matthew John Mitchell, IDC
• Mark William Mittauer, MD
• Amy L Moncy, CCC-SLP
• Kristin Montgomery
• Matthew Isiah Morrison
• Austin Shane Morrow, SUBFOR IDC
• Kelsey Christine Morton

• Pharmacotherapy Pharmacist in Groton, CT
• Providers in Groton, CT by specialty
• Pharmacotherapy Pharmacist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.