Individual provider Active NPI

Nicholas Ronald Lariviere, PHARM. D

  • Pharmacist
  • West Haven, CT
National Provider Identifier
1023393824
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT.0010150 Issued in CT
Practice address
600 Derby Ave
West Haven, CT 06516-1000
Phone
(833) 487-9644
Fax
(203) 867-5593
NPI assigned
Oct 13, 2011
Last updated
Sep 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PCT.0010150 CT Primary

Addresses

Primary practice location

600 Derby Ave
West Haven, CT 06516-1000

Mailing address

600 Derby Ave
West Haven, CT 06516-1000
Phone (833) 487-9644

Other practice location 1

1606 Barnum Avenue
Stratford, CT 06614
Phone (203) 377-2851

Other practice location 2

1100 Sherman Ave
Hamden, CT 06514-1363
Phone (203) 747-7589

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PCT.0010150CTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Center Pharmacy and Home Care Center, Inc. CurrentSince Sep 23, 2024 Accepting new patients
Walgreen Co Past Accepting new patients
Walgreen Co Past Accepting new patients
Medical Center Pharmacy and Home Care Center, Inc. PastSince Sep 23, 2024 Accepting new patients

Locations

1100 Sherman Ave
Hamden, CT 06514
Phone (203) 747-3933

600 Derby Ave
West Haven, CT 06516
Phone (203) 479-3057

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1318464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1023393824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 DERBY AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065161000",
            "telephone_number": "833-487-9644",
            "fax_number": "203-867-5593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 DERBY AVE",
            "city": "WEST HAVEN",
            "state": "CT",
            "postal_code": "065161000",
            "telephone_number": "833-487-9644",
            "fax_number": "203-867-5593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1606 Barnum Avenue",
            "address_purpose": "LOCATION",
            "city": "Stratford",
            "state": "CT",
            "postal_code": "06614",
            "country_code": "US",
            "telephone_number": "203-377-2851",
            "fax_number": "203-378-3530",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Sherman Ave",
            "address_purpose": "LOCATION",
            "city": "Hamden",
            "state": "CT",
            "postal_code": "065141363",
            "country_code": "US",
            "telephone_number": "203-747-7589",
            "fax_number": "203-867-5593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARIVIERE",
        "first_name": "NICHOLAS",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "PHARM. D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-13",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0010150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.