Provider Demographics
NPI:1780382853
Name:PIERCE, TERRIN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:TERRIN
Middle Name:
Last Name:PIERCE
Suffix:
Gender:
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CAMPBELL AVE APT 124
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-8912
Mailing Address - Country:US
Mailing Address - Phone:607-952-0056
Mailing Address - Fax:
Practice Address - Street 1:705 BRIDGEPORT AVE
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-4704
Practice Address - Country:US
Practice Address - Phone:203-447-7013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT.0016216183500000X
NY068941183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist