Provider Demographics
NPI:1740595446
Name:OKPOR, STANLEY OKECHUKWU
Entity Type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:OKECHUKWU
Last Name:OKPOR
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 1:1700 BUTLER PIKE APT 11E
Mailing Address - Street 2:
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-1254
Mailing Address - Country:US
Mailing Address - Phone:484-362-9002
Mailing Address - Fax:
Practice Address - Street 1:119 E BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:LANSDOWNE
Practice Address - State:PA
Practice Address - Zip Code:19050-2214
Practice Address - Country:US
Practice Address - Phone:610-622-8191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP442313183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist