Individual provider Active NPI

Maydelin Rives Santiesteban, PHARMD

  • Pharmacist
  • Brooklyn, CT
National Provider Identifier
1720949498
Registry record updated Nov 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PCT.0017121 Issued in CT
Practice address
450 Providence Rd
Brooklyn, CT 06234-1823
Phone
(860) 412-5137
NPI assigned
Nov 20, 2025
Last updated
Nov 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2025

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.0017121 CT Primary

Addresses

Primary practice location

450 Providence Rd
Brooklyn, CT 06234-1823

Mailing address

1 Triton SQ Apt 2123
Groton, CT 06340-3460
Phone (239) 200-5436

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.0017121CTMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1763596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763596800000",
    "number": "1720949498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 TRITON SQ APT 2123",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063403460",
            "telephone_number": "239-200-5436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 PROVIDENCE RD",
            "city": "BROOKLYN",
            "state": "CT",
            "postal_code": "062341823",
            "telephone_number": "860-412-5137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIVES SANTIESTEBAN",
        "first_name": "MAYDELIN",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-11-20",
        "last_updated": "2025-11-20",
        "certification_date": "2025-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CT",
            "license": "PCT.0017121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2025; 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.