Provider Demographics
NPI:1114459260
Name:STORK, ABBY
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:STORK
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 1:300 HALKET STREET
Mailing Address - Street 2:MAGEE-WOMENS HOSPITAL OF UPMC
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3410
Mailing Address - Country:US
Mailing Address - Phone:412-641-4455
Mailing Address - Fax:
Practice Address - Street 1:10707 W 87TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66214-1652
Practice Address - Country:US
Practice Address - Phone:913-262-3000
Practice Address - Fax:913-262-3002
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KS04-50036207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program