Active NPI
Ilyevu Kalontarov, RPH
- Pharmacist
- Forest Hills, NY
National Provider Identifier
1922320027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 053042
- Practice address
- 10225 67TH Dr Apt 5W
Forest Hills, NY 11375-2874 - Phone
- (631) 319-6877
- Fax
- (888) 577-8740
- NPI assigned
- Feb 17, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 053042 | NY | Primary |
Addresses
Primary practice location
10225 67TH Dr Apt 5W
Forest Hills, NY 11375-2874
Mailing address
102-25 67 Drive Apt 5W
Forest Hills, NY 11375
Phone (631) 319-6877
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 053042 | Other | NY | LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 053042 | NY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daily Dose RX LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449792000000",
"number": "1922320027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102-25 67 DRIVE APT 5W",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "11375",
"telephone_number": "631-319-6877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10225 67TH DR APT 5W",
"city": "FOREST HILLS",
"state": "NY",
"postal_code": "113752874",
"telephone_number": "631-319-6877",
"fax_number": "888-577-8740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KALONTAROV",
"first_name": "ILYEVU",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-02-17",
"last_updated": "2015-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "053042",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "053042",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Forest Hills, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.