Healthcare Provider Details

I. General information

NPI: 1770466286
Provider Name (Legal Business Name): KYLEIGH STORRS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 NORTH ST STE 2
AUBURN NY
13021-1852
US

IV. Provider business mailing address

17 LANSING ST
AUBURN NY
13021-1983
US

V. Phone/Fax

Practice location:
  • Phone: 315-252-5028
  • Fax: 315-252-1587
Mailing address:
  • Phone: 315-252-5028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: