Provider Demographics
NPI:1033278460
Name:O'BRIEN, TERRENCE E (RPH)
Entity Type:Individual
Prefix:MR
First Name:TERRENCE
Middle Name:E
Last Name:O'BRIEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 HENDRICKSON LN
Mailing Address - Street 2:
Mailing Address - City:UNIONVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06085-1091
Mailing Address - Country:US
Mailing Address - Phone:860-673-1640
Mailing Address - Fax:
Practice Address - Street 1:900 COTTAGE GROVE RD, B5PHR
Practice Address - Street 2:CIGNA HEALTHCARE
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06152
Practice Address - Country:US
Practice Address - Phone:860-226-8567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2011-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT8795183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist