Provider Demographics
NPI:1164751152
Name:CADORETTE, ELAINE M (PAC)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:M
Last Name:CADORETTE
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:M
Other - Last Name:DURKEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:100 FODEN RD.
Mailing Address - Street 2:WEST BUILDING SUITE 103
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-2351
Mailing Address - Country:US
Mailing Address - Phone:207-828-1122
Mailing Address - Fax:207-828-0188
Practice Address - Street 1:100 FODEN RD.
Practice Address - Street 2:WEST BUILDING SUITE 103
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2351
Practice Address - Country:US
Practice Address - Phone:207-774-9839
Practice Address - Fax:207-761-2127
Is Sole Proprietor?:No
Enumeration Date:2009-12-22
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical