Active NPI
Carissa Fava
- Pharmacist
- New London, CT
National Provider Identifier
1952787434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH05471
- Practice address
- 365 Montauk Ave
New London, CT 06320-4700 - Phone
- (401) 632-8362
- NPI assigned
- Aug 6, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PCT.0013810 | CT | |
| Pharmacist | 183500000X | RPH05471 | RI | Primary |
Addresses
Primary practice location
365 Montauk Ave
New London, CT 06320-4700
Mailing address
1 Cleo CT
Westerly, RI 02891-1334
Other practice location 1
25 Wells St
Westerly, RI 02891-2922
Phone (401) 632-8362
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.0013810 | CT | MD | Pharmacist |
| RPH05471 | RI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778457600000",
"number": "1952787434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 CLEO CT",
"city": "WESTERLY",
"state": "RI",
"postal_code": "028911334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "365 MONTAUK AVE",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063204700",
"telephone_number": "401-632-8362"
}
],
"practiceLocations": [
{
"address_1": "25 Wells St",
"address_purpose": "LOCATION",
"city": "Westerly",
"state": "RI",
"postal_code": "028912922",
"country_code": "US",
"telephone_number": "401-632-8362",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FAVA",
"first_name": "CARISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-06",
"last_updated": "2026-05-11",
"certification_date": "2026-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CT",
"license": "PCT.0013810",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "RI",
"license": "RPH05471",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New London, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.