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Individual

MAYDELIN RIVES SANTIESTEBAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARMD

Contact information

Practice address
450 PROVIDENCE RD, BROOKLYN, CT 06234-1823
(860) 412-5137
Mailing address
1 TRITON SQ APT 2123, GROTON, CT 06340-3460
(239) 200-5436

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PCT.0017121
CT

Other

Enumeration date
11/20/2025
Last updated
11/20/2025
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