MEDICARE: ILYA REZNIKOV PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	59305	TX
2	183500000X	Pharmacist	20634	NV

General Provider Information

NPI Number	:	1275462343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ILYA REZNIKOV PHARMD

Provider Business Mailing Address
First Line	:	1110 ECHO PASS ST
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89052-3801
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2720 N TENAYA WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0424
Country	:	US
Telephone Number	:	702-242-7300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2026
Last Update Date	:	05/15/2026

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Directions to “ ILYA REZNIKOV PHARMD” Practice Location

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