Provider Demographics
NPI:1548261332
Name:LEVY, GERALD STANTON (RPH-PHARMACIST)
Entity type:Individual
Prefix:MR
First Name:GERALD
Middle Name:STANTON
Last Name:LEVY
Suffix:
Gender:M
Credentials:RPH-PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 HARRISON ST
Mailing Address - Street 2:LEADER/KRESS DRUGS
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13202-3096
Mailing Address - Country:US
Mailing Address - Phone:315-476-4074
Mailing Address - Fax:315-476-1344
Practice Address - Street 1:550 HARRISON ST
Practice Address - Street 2:LEADER/KRESS DRUGS
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13202-3096
Practice Address - Country:US
Practice Address - Phone:315-476-4074
Practice Address - Fax:315-476-1344
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY27907183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist