MEDICARE: 182 AVE CHEMISTS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1700670692
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	182 AVE CHEMISTS INC

Provider Business Mailing Address
First Line	:	18235 JAMAICA AVE
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11423-2329
Country	:	US
Telephone Number	:	347-238-1398
Fax Number	:	347-238-1368

Provider Business Practice Location Address
First Line	:	18235 JAMAICA AVE
Second Line	:
City	:	JAMAICA
State	:	NY
Zip	:	11423-2329
Country	:	US
Telephone Number	:	347-238-1398
Fax Number	:	347-238-1368

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DIMITRIY NIYAZOV
Credential	:
Telephone Number	:	347-238-1398

Provider Enumeration Date	:	04/07/2025
Last Update Date	:	11/19/2025

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