National Provider Identifier

Stacy R Mack

Stacy R Mack is listed in the NPPES registry with a primary specialty of Driver in Rochester, NY and a listed phone number of (585) 704-0974.

NPI 1972367696Rochester, NYDriver

Profile Overview

NPI
1972367696
Provider Type
Individual
Primary Specialty
Driver
Enumeration Date
February 13, 2024
Last Updated
February 21, 2024

Practice Location

  • 16 Atlee Drive
  • Lower
  • Rochester, NY 14626

Phone: (585) 704-0974

Mailing Address

  • 1370 W Ridge RD # 1077
  • Rochester, NY 14615-2418

Specialties

  • Driver (172A00000X)
Full Record
NPI
1972367696
Entity Type
Individual
Last Name
Mack
First Name
Stacy
Middle Name
R
Mailing Street Address
1370 W Ridge RD # 1077
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14615-2418
Mailing Country
US
Mailing Phone
(585) 443-6688
Practice Street Address
16 Atlee Drive
Practice Address Line 2
Lower
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14626
Practice Country
US
Practice Phone
(585) 704-0974
Enumeration Date
February 13, 2024
Last Updated
February 21, 2024
Sex
Female
Sole Proprietor
No
Certification Date
February 21, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Driver (172A00000X)