Active NPI
Maia Determan
- Pharmacotherapy Pharmacist
- New Haven, CT
National Provider Identifier
1497324503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- PCT.0015719
- Practice address
- 55 Park St
New Haven, CT 06511-5474 - Phone
- (203) 688-4242
- NPI assigned
- Jun 22, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | PCT.0015719 | CT | Primary |
Addresses
Primary practice location
55 Park St
New Haven, CT 06511-5474
Mailing address
55 Park St
New Haven, CT 06511-5474
Other practice location 1
20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCT.0015719 | CT | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624320000000",
"number": "1497324503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 PARK ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065115474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 PARK ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065115474",
"telephone_number": "203-688-4242"
}
],
"practiceLocations": [
{
"address_1": "20 York St",
"address_purpose": "LOCATION",
"city": "New Haven",
"state": "CT",
"postal_code": "065103220",
"country_code": "US",
"telephone_number": "203-688-4242",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DETERMAN",
"first_name": "MAIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-06-22",
"last_updated": "2021-06-22",
"certification_date": "2021-06-22",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "CT",
"license": "PCT.0015719",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.