Organization Active NPI

Long Island Pharmacy Corp

  • Pharmacy
  • Hewlett, NY
National Provider Identifier
1285335976
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
LONG ISLAND PHARMACY CORP
Practice address
1163A Broadway
Hewlett, NY 11557-2321
Phone
(516) 218-2654
Fax
(516) 218-2655
NPI assigned
Mar 10, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Authorized official

Name
Elona DavidovaNPI 1174930937
Title
Owner
Phone
(516) 218-2654

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Pharmacy 333600000X Primary

Addresses

Primary practice location

1163A Broadway
Hewlett, NY 11557-2321

Mailing address

1163A Broadway
Hewlett, NY 11557-2321
Phone (516) 218-2654

Other identifiers 1

IdentifierTypeStateIssuer
040121OtherNYSTATE BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230418002515 NY Part B Supplier - Mass Immunization (Roster Biller Only) 9335514660 Practice locations: Hewlett, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762128000000",
    "number": "1285335976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1163A BROADWAY",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115572321",
            "telephone_number": "516-218-2654",
            "fax_number": "516-218-2655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1163A BROADWAY",
            "city": "HEWLETT",
            "state": "NY",
            "postal_code": "115572321",
            "telephone_number": "516-218-2654",
            "fax_number": "516-218-2655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LONG ISLAND PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-10",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A",
        "authorized_official_last_name": "DAVIDOVA",
        "authorized_official_first_name": "ELONA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-218-2654"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BOARD",
            "identifier": "040121",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hewlett, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; 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.