Healthcare Provider Details

I. General information

NPI: 1821950627
Provider Name (Legal Business Name): ASHLEY JOE PAILY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 COMMUNITY DR
MANHASSET NY
11030-3876
US

IV. Provider business mailing address

95 RHODES DR
NEW HYDE PARK NY
11040-3527
US

V. Phone/Fax

Practice location:
  • Phone: 516-562-0100
  • Fax:
Mailing address:
  • Phone: 516-865-2520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number071380
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: