Provider Demographics
NPI:1184995573
Name:CODERRE, KAREN M (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:M
Last Name:CODERRE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 BOGAN RD
Mailing Address - Street 2:
Mailing Address - City:MONSON
Mailing Address - State:MA
Mailing Address - Zip Code:01057-9774
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 MONARCH PL
Practice Address - Street 2:SUITE 1500
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01144-1500
Practice Address - Country:US
Practice Address - Phone:413-233-3409
Practice Address - Fax:413-233-2777
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-18
Last Update Date:2012-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1195861835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric