Active NPI
Nicole Mariann Macniak, PHARMD
- Pharmacist
- West Hartford, CT
National Provider Identifier
1093319691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PCT.0015376
- Practice address
- 1099 New Britain Ave
West Hartford, CT 06110-2418 - Phone
- (860) 236-6181
- NPI assigned
- Nov 24, 2020
- Last updated
- Nov 24, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PCT.0015376 | CT | Primary |
Addresses
Primary practice location
1099 New Britain Ave
West Hartford, CT 06110-2418
Mailing address
267 Audubon Ave
Newington, CT 06111-3509
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
| License | State | Type | Specialty |
|---|---|---|---|
| PCT.0015376 | CT | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connecticut CVS Pharmacy, L.L.C. | Past | Accepting new patients | |
| Connecticut CVS Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 2
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": "1606176000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606176000000",
"number": "1093319691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "267 AUDUBON AVE",
"city": "NEWINGTON",
"state": "CT",
"postal_code": "061113509"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1099 NEW BRITAIN AVE",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061102418",
"telephone_number": "860-236-6181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACNIAK",
"first_name": "NICOLE",
"middle_name": "MARIANN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-11-24",
"last_updated": "2020-11-24",
"certification_date": "2020-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0015376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.