Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Stacey M Banta

Individual provider Pharmacist · NPI 1558684852

Stacey M Banta is a Pharmacist in Cicero, New York. Practices as a sole proprietor. Licensed in Massachusetts and New York.

Licensed in
MA, NY
In the registry since
2010
Specialties on file
2
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Practice location Address checks out

6189 Route 31 Walgreens Pharmacy
Cicero, NY 13039
Phone: (315) 699-0812
Fax: (315) 699-0818
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 051406 (NY)
Pharmacist Taxonomy 183500000X · Licence PH21046 (MA)

Record details

NPI number1558684852
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 2, 2010
Last updated in NPPESMarch 2, 2010

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