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

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
Mailing address4945 Tinderbox Cir, Manlius, NY 13104-2131

Other providers in Cicero