Healthcare Provider Details

I. General information

NPI: 1861323362
Provider Name (Legal Business Name): HYLAN MED CABINET LTC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1988 HYLAN BLVD FL 2
STATEN ISLAND NY
10306-3526
US

IV. Provider business mailing address

1988 HYLAN BLVD FL 2
STATEN ISLAND NY
10306-3526
US

V. Phone/Fax

Practice location:
  • Phone: 718-667-4300
  • Fax: 888-733-0373
Mailing address:
  • Phone: 718-667-4300
  • Fax: 888-733-0373

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: MOHAMED AHMED ALY
Title or Position: VICE PRESIDENT
Credential:
Phone: 929-330-3127