Provider Demographics
NPI:1356044861
Name:SIKORA, COREY JAY (RPH)
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:JAY
Last Name:SIKORA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ARGONNE DR
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:NY
Mailing Address - Zip Code:14217-2430
Mailing Address - Country:US
Mailing Address - Phone:716-697-6361
Mailing Address - Fax:
Practice Address - Street 1:20 ARGONNE DR
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-2430
Practice Address - Country:US
Practice Address - Phone:716-697-6361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-23
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070124183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist