Provider Demographics
NPI:1801343298
Name:PIERCE, DEIRDRE P
Entity type:Individual
Prefix:DR
First Name:DEIRDRE
Middle Name:P
Last Name:PIERCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8305 HAMMOCKS DR
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-8531
Mailing Address - Country:US
Mailing Address - Phone:315-247-9182
Mailing Address - Fax:585-385-8453
Practice Address - Street 1:3860 EAST AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3729
Practice Address - Country:US
Practice Address - Phone:585-385-7380
Practice Address - Fax:585-385-8453
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-02
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY35551183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist