Sai Siva Pharmacy LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

SAI SIVA PHARMACY LLC

Doing business as

Kings Park Pharmacy

Practice address

64 Indian Head Rd
Kings Park, NY 11754-3703

Phone

(631) 663-3800

Fax

(631) 663-3799

NPI assigned

Mar 31, 2020

Last updated

Jul 29, 2025By 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

Rajasekhar Kantamneni

Title

Manaing Member

Phone

(631) 663-3800

Specialties & licenses 1

Addresses

Other names 1

• Kings Park Pharmacy Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Practitioners 4

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.

• Issam Samir Abdalla, PHARMD

  • Pharmacist
  • Kings Park, NY
  • NPI 1215541891
  NPD
• George Angelopoulos, PHARM.D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Kings Park, NY
  • NPI 1265709265
  NPD
• Alexander Russo, PHARMD

  • Pharmacist
  • Kings Park, NY
  • NPI 1205429925
  NPD
• Nicholas Niceforo, PHARM.D

  • Ambulatory Care Pharmacist
  • Jamaica, NY
  • NPI 1548776966
  NPD (past)

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753747200000",
    "number": "1881222164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 INDIAN HEAD RD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117543703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 INDIAN HEAD RD",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "117543703",
            "telephone_number": "631-663-3800",
            "fax_number": "631-663-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAI SIVA PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-31",
        "last_updated": "2025-07-29",
        "certification_date": "2025-07-29",
        "status": "A",
        "authorized_official_last_name": "KANTAMNENI",
        "authorized_official_first_name": "RAJASEKHAR",
        "authorized_official_title_or_position": "MANAING MEMBER",
        "authorized_official_telephone_number": "631-663-3800"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpp64@optimum.net",
            "affiliation": "N",
            "endpointDescription": "pharmacy email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 Indian Head Rd",
            "city": "Kings Park",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117543703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kings Park Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kings Park Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Alex John Rupp
• Amanda Brooke Russell Schmidt, M.A. CCC-SLP
• Alexander Russo, PHARMD
• Joan Ann Ryan, R.N.
• Zachary Philip Sabella
• San Remo Super Pharmacy Inc. (San Remo Pharmacy)
• Ivelisse Baby Sanchez, RN
• Madeleine Marie Santoro, LMT
• Katelyn Santos, OTR/L
• Lisa Maria Schlossberg

• Community/Retail Pharmacy in Kings Park, NY
• Providers in Kings Park, 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 Jul 29, 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.