Provider Demographics
NPI:1558511915
Name:STAROPOLI, JAMES R (RPH)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:STAROPOLI
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 1:5701 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-4801
Mailing Address - Country:US
Mailing Address - Phone:631-218-8636
Mailing Address - Fax:631-218-8638
Practice Address - Street 1:5701 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:NY
Practice Address - Zip Code:11741-4801
Practice Address - Country:US
Practice Address - Phone:631-218-8636
Practice Address - Fax:631-218-8638
Is Sole Proprietor?:No
Enumeration Date:2008-09-23
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY39004183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02071185Medicaid