Provider Demographics
NPI:1689260655
Name:KOCJAN, PIERCE MONROE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PIERCE
Middle Name:MONROE
Last Name:KOCJAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SEMB DR
Mailing Address - Street 2:
Mailing Address - City:ERVING
Mailing Address - State:MA
Mailing Address - Zip Code:01344-4414
Mailing Address - Country:US
Mailing Address - Phone:413-422-1191
Mailing Address - Fax:
Practice Address - Street 1:250 PLAINFIELD RD
Practice Address - Street 2:
Practice Address - City:WEST LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03784-2000
Practice Address - Country:US
Practice Address - Phone:603-298-8350
Practice Address - Fax:603-298-0547
Is Sole Proprietor?:No
Enumeration Date:2020-12-14
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT033.0134355183500000X
CTPCT.0015145183500000X
MAPH238714183500000X
NHPHCY-00986183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist