Individual provider Active NPI

Jessica Diala, PHARMD, RPH

  • Community/Retail Pharmacy
  • Bellerose, NY
National Provider Identifier
1063939072
Registry record updated Sep 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
073399 Issued in NY
Practice address
24771 Jericho Tpke
Bellerose, NY 11426-1533
Phone
(718) 749-5923
Fax
(718) 749-5924
NPI assigned
Aug 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 073399 NY Primary
Pharmacist 183500000X 25591 MD
Pharmacist 183500000X 28RI03852800 NJ

Addresses

Primary practice location

24771 Jericho Tpke
Bellerose, NY 11426-1533

Mailing address

24771 Jericho Tpke
Bellerose, NY 11426-1533
Phone (718) 749-5923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI03852800NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789084800000",
    "number": "1063939072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24771 JERICHO TPKE",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114261533",
            "telephone_number": "718-749-5923",
            "fax_number": "718-749-5924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24771 JERICHO TPKE",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114261533",
            "telephone_number": "718-749-5923",
            "fax_number": "718-749-5924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIALA",
        "first_name": "JESSICA",
        "name_prefix": "Dr.",
        "credential": "PHARMD, RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-30",
        "last_updated": "2026-09-11",
        "certification_date": "2026-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "073399",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MD",
            "license": "25591",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03852800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellerose, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.