Provider Demographics
NPI:1720364300
Name:FOLDEAK, ELENA M (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:ELENA
Middle Name:M
Last Name:FOLDEAK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MISS
Other - First Name:ELENA
Other - Middle Name:M
Other - Last Name:MALIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:1083 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3550
Mailing Address - Country:US
Mailing Address - Phone:203-878-7265
Mailing Address - Fax:
Practice Address - Street 1:1083 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3550
Practice Address - Country:US
Practice Address - Phone:203-878-7265
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0009772183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist