Healthcare Provider Details

I. General information

NPI: 1235091067
Provider Name (Legal Business Name): QUEENSPHARM RX, CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

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

9601 63RD DR
REGO PARK NY
11374
US

IV. Provider business mailing address

9601 63RD DR
REGO PARK NY
11374
US

V. Phone/Fax

Practice location:
  • Phone: 347-730-5115
  • Fax: 347-923-3007
Mailing address:
  • Phone: 347-730-5115
  • Fax: 347-923-3007

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: DILAFRUZ SHOKIROVA
Title or Position: PRESIDENT
Credential:
Phone: 347-730-5115