Khelly Ny II Inc.

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

031875 Issued in NV

Legal business name

KHELLY NY II INC.

Doing business as

Eastchester Pharmacy

Practice address

2102 Eastchester Rd
Bronx, NY 10461-2248

Phone

(718) 684-5454

Fax

(718) 684-5456

NPI assigned

Apr 19, 2013

Last updated

Dec 24, 2019By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Bhavna A Shah

Title

President

Phone

(732) 318-9628

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• EASTCHESTER PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angie Paulino

  • Pharmacy Technician
  • Bronx, NY
  • NPI 1851257232
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577145600000",
    "number": "1053755173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 EASTCHESTER RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612248",
            "telephone_number": "718-684-5454",
            "fax_number": "718-684-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 EASTCHESTER RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104612248",
            "telephone_number": "718-684-5454",
            "fax_number": "718-684-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHELLY NY II INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-19",
        "last_updated": "2019-12-24",
        "certification_date": "2019-12-24",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "BHAVNA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-318-9628",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NV",
            "license": "031875",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3808188",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "7122950001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD OF PHARMACY, NEWYORK",
            "identifier": "031875",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EASTCHESTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EASTCHESTER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aleksandr Khaykin, DDS
• Noushin Khazaei
• Magdana Khelashvili
• Beshoy Khella
• Khelly (Ny) Inc (Gunhill Pharmacy)
• Deepa Khemani, MD
• Lavina Khemani, MD
• Irina Khetsuriani
• Lasha Khetsuriani
• Marina Kheyfets

• Community/Retail Pharmacy in Bronx, NY
• Providers in Bronx, NY by specialty
• Community/Retail Pharmacy in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.