175 Jericho Pharmacy Corp

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

036613 Issued in NY

Legal business name

175 JERICHO PHARMACY CORP

Doing business as

Pill Cloud RX of Long Island

Practice address

175 Jericho Tpke
West Lobby Suite
Syosset, NY 11791-4532

Phone

(516) 865-1151

Fax

(844) 440-2401

NPI assigned

May 31, 2018

Last updated

Sep 30, 2024By 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

Benjamin Tsadyk

Title

President

Phone

(516) 865-1151

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PILL CLOUD RX OF LONG ISLAND Doing business as

Medicare fee-for-service enrollment

Enrolled in NY3 enrollments

Enrollment records 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• 50 Oceana Pharmacy Corp

  dba Oceana Pharmacy

  • Community/Retail Pharmacy
  • Brooklyn, NY
  • NPI 1972096758

  Member Of

  NPD member
• Deliver My Meds Corp

  • Durable Medical Equipment & Medical Supplies
  • Plano, TX
  • NPI 1265990113

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1699267120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 JERICHO TPKE LBBY SUITE",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914532",
            "telephone_number": "516-865-1151",
            "fax_number": "844-440-2401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 JERICHO TPKE",
            "address_2": "WEST LOBBY SUITE",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914532",
            "telephone_number": "516-865-1151",
            "fax_number": "844-440-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "175 JERICHO PHARMACY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "TSADYK",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-865-1151"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NY",
            "license": "036613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY",
            "identifier": "036613",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PILL CLOUD RX OF LONG ISLAND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• A Step Ahead Therapy Services, LLC
• Noor Ul Aan
• Daniel Anertey Abbey Sr.
• Monika Abdrakhmanova
• Daniella Abramov

• Community/Retail Pharmacy in Syosset, NY
• Providers in Syosset, 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 Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.