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General NPI Number Information
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NPI Number | 1285335976
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Entity Type | Organization
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Legal Business Name | LONG ISLAND PHARMACY CORP
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Dates
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Enumeration Date | 03/10/2023
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 1163A BROADWAY
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City | HEWLETT
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State | NY
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Zip | 11557-2321
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Country | US
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Telephone | 516-218-2654
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Fax | 516-218-2655
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Provider Business Mailing Address
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Address Line | 1163A BROADWAY
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City | HEWLETT
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State | NY
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Zip | 11557-2321
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Country | US
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Telephone | 516-218-2654
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Fax | 516-218-2655
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Authorized Official
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Title or Position | OWNER
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Name | ELONA DAVIDOVA
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Credential |
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Telephone | 516-218-2654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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