Healthcare Provider Details

I. General information

NPI: 1457282865
Provider Name (Legal Business Name): STATION PHARMACY NY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1757 NEW YORK AVE
HUNTINGTON STATION NY
11746-2407
US

IV. Provider business mailing address

1757 NEW YORK AVE
HUNTINGTON STATION NY
11746-2407
US

V. Phone/Fax

Practice location:
  • Phone: 631-418-8953
  • Fax: 631-418-8954
Mailing address:
  • Phone: 631-418-8953
  • Fax: 631-418-8954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DALER RAKHMONOV
Title or Position: OWNER
Credential:
Phone: 718-629-8940