Physio Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

PHYSIO PHARMACY INC

Practice address

488A E Jericho Tpke
Huntington Station, NY 11746-7312

Phone

(631) 424-0125

Fax

(631) 385-1582

NPI assigned

Dec 8, 2023

Organization subpart

No

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

Authorized official

Name

Ilya Sholomov

Title

Owner

Phone

(631) 424-0125

Specialties & licenses 2

Addresses

Other names 1

• Rx Expresso Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

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

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761868800000",
    "number": "1346017332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "488A E JERICHO TPKE",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117467312",
            "telephone_number": "631-424-0125",
            "fax_number": "631-385-1582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "488A E JERICHO TPKE",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117467312",
            "telephone_number": "631-424-0125",
            "fax_number": "631-385-1582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIO PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-08",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A",
        "authorized_official_last_name": "SHOLOMOV",
        "authorized_official_first_name": "ILYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-424-0125"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rx Expresso",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elba A Pena
• Shenna Marie Pendarvis
• Ruthann Perillo, MD
• Rachel Pessah Pollack, M.D.
• Florentia Georgianna Petrides
• Patricia Pigeot
• Jessica Pinder
• Lauren Anne Pine, DO
• Kristen Plant, OTR/L
• David Plosky, DMD

• Community/Retail Pharmacy in Huntington Station, NY
• Providers in Huntington Station, 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 Oct 31, 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.