Healthcare Provider Details

I. General information

NPI: 1235068255
Provider Name (Legal Business Name): ISRA JILANI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 JACKSON AVE
LONG ISLAND CITY NY
11101-5095
US

IV. Provider business mailing address

2501 JACKSON AVE
LONG ISLAND CITY NY
11101-5095
US

V. Phone/Fax

Practice location:
  • Phone: 718-310-5540
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number069945
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: