National Provider Identifier
Corey Alexander Stack, PA
Corey Alexander Stack, PA is listed in the NPPES registry with a primary specialty of Physician Assistant in Lockport, NY and a listed phone number of (716) 727-2018.
Profile Overview
- NPI
- 1487447538
- Provider Type
- Individual
- Primary Specialty
- Physician Assistant
- Enumeration Date
- May 22, 2025
- Last Updated
- May 22, 2025
Practice Location
- 5801 S Transit RD
- Lockport, NY 14094-5811
Phone: (716) 727-2018
Mailing Address
- 480 Aberdeen RD
- Lewiston, NY 14092-1023
Specialties
- Physician Assistant (363A00000X)
Full Record
- NPI
- 1487447538
- Entity Type
- Individual
- Last Name
- Stack
- First Name
- Corey
- Middle Name
- Alexander
- Credential
- PA
- Mailing Street Address
- 480 Aberdeen RD
- Mailing City
- Lewiston
- Mailing State
- NY
- Mailing ZIP Code
- 14092-1023
- Mailing Country
- US
- Mailing Phone
- (830) 563-7390
- Practice Street Address
- 5801 S Transit RD
- Practice City
- Lockport
- Practice State
- NY
- Practice ZIP Code
- 14094-5811
- Practice Country
- US
- Practice Phone
- (716) 727-2018
- Enumeration Date
- May 22, 2025
- Last Updated
- May 22, 2025
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- May 22, 2025
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physician Assistant (363A00000X)