Habib Thiam

Primary specialty

PharmacistTaxonomy code 183500000X

License

PCT.0015506 Issued in CT

Practice address

90 Halls Rd
Old Lyme, CT 06371

Phone

(860) 434-8111

NPI assigned

Feb 18, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1205429362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 HALLS RD",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "06371",
            "telephone_number": "860-434-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 HALLS RD",
            "city": "OLD LYME",
            "state": "CT",
            "postal_code": "06371",
            "telephone_number": "860-434-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIAM",
        "first_name": "HABIB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0015506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "telephone",
            "affiliation": "N",
            "address_1": "90 halls rd",
            "city": "old lyme",
            "state": "CT",
            "country_code": "US",
            "postal_code": "06371",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pharmacist in Old Lyme, CT
• Providers in Old Lyme, CT by specialty
• Pharmacist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.