Organization Active NPI

Skylight Pharmacy Inc

  • Community/Retail Pharmacy
  • Jamaica, NY
National Provider Identifier
1396492112
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SKYLIGHT PHARMACY INC
Practice address
15334 Hillside Ave
Jamaica, NY 11432-3322
Phone
(718) 880-1720
Fax
(718) 880-1376
NPI assigned
Mar 2, 2022
Last updated
Mar 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Authorized official

Name
Dr. Albina Rafailova, PHARM.D.NPI 1629522073
Title
President
Phone
(718) 880-1720

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

15334 Hillside Ave
Jamaica, NY 11432-3322

Mailing address

15334 Hillside Ave
Jamaica, NY 11432-3322
Phone (718) 880-1720

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221007001293 NY Part B Supplier - Mass Immunization (Roster Biller Only) 3971989302 Practice locations: Jamaica, 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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646265600000",
    "number": "1396492112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15334 HILLSIDE AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323322",
            "telephone_number": "718-880-1720",
            "fax_number": "718-880-1376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15334 HILLSIDE AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323322",
            "telephone_number": "718-880-1720",
            "fax_number": "718-880-1376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLIGHT PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A",
        "authorized_official_last_name": "RAFAILOVA",
        "authorized_official_first_name": "ALBINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-880-1720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.