Provider Demographics
NPI:1124729728
Name:FEARY, CORY JAMES
Entity type:Individual
Prefix:
First Name:CORY
Middle Name:JAMES
Last Name:FEARY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2659 PEARL STREET RD
Mailing Address - Street 2:
Mailing Address - City:CORFU
Mailing Address - State:NY
Mailing Address - Zip Code:14036-9634
Mailing Address - Country:US
Mailing Address - Phone:585-815-9075
Mailing Address - Fax:
Practice Address - Street 1:4155 W MAIN STREET RD
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1240
Practice Address - Country:US
Practice Address - Phone:585-344-2916
Practice Address - Fax:585-344-2916
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician