Provider Demographics
NPI:1730283755
Name:STAPOLSY, GARY
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:
Last Name:STAPOLSY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:US ARMY MEDICAL DEPARTMENT ACTIVITY, JAPAN
Mailing Address - Street 2:UNIT 45011, BLDG 704, ATTN: MCJA-QM
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96338-5011
Mailing Address - Country:JP
Mailing Address - Phone:0118146-407-8206
Mailing Address - Fax:0118146-407-8183
Practice Address - Street 1:301 BYBERRY RD
Practice Address - Street 2:APPT. B12
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19116-1947
Practice Address - Country:US
Practice Address - Phone:215-671-0510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP038012L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist