Healthcare Provider Details

I. General information

NPI: 1700792777
Provider Name (Legal Business Name): HEALTHORA PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 JERICHO TPKE
FLORAL PARK NY
11001-2207
US

IV. Provider business mailing address

360 JERICHO TPKE
FLORAL PARK NY
11001-2207
US

V. Phone/Fax

Practice location:
  • Phone: 516-216-5908
  • Fax: 516-216-5909
Mailing address:
  • Phone: 516-216-5908
  • Fax: 516-216-5909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RAFOYEL MULOKANDOV
Title or Position: OWNER
Credential:
Phone: 516-216-5908