Provider Demographics
NPI:1427239920
Name:KENSY, STACY ANN (PHARM D)
Entity type:Individual
Prefix:DR
First Name:STACY
Middle Name:ANN
Last Name:KENSY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:MISS
Other - First Name:STACY
Other - Middle Name:ANN
Other - Last Name:SROKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:2101 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14207-1908
Mailing Address - Country:US
Mailing Address - Phone:716-515-0055
Mailing Address - Fax:716-515-0069
Practice Address - Street 1:2101 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14207-1908
Practice Address - Country:US
Practice Address - Phone:716-515-0055
Practice Address - Fax:716-515-0069
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051827183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist