Healthcare Provider Details

I. General information

NPI: 1073438818
Provider Name (Legal Business Name): SJS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 E BURNSIDE AVE
BRONX NY
10453-4142
US

IV. Provider business mailing address

105 E BURNSIDE AVE
BRONX NY
10453-4142
US

V. Phone/Fax

Practice location:
  • Phone: 718-933-1222
  • Fax: 718-933-1255
Mailing address:
  • Phone: 718-933-1222
  • Fax: 718-933-1255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ZAKHAR ILYAICH
Title or Position: VP
Credential:
Phone: 347-915-0952