OrganizationActive
1105 Jtp LLC
NPI 1982243788 · Community/Retail Pharmacy · New Hyde Park, NY
Provider details
- NPI number
- 1982243788
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Authorized official
- Ishbay Shukurov, Owner
Practice location
1105 Jericho Tpke
New Hyde Park, NY 11040-4603
Phone: (516) 775-7775
Mailing address
1105 Jericho Tpke
New Hyde Park, NY 11040-4603
Registry dates
- Enumerated
- 2019-12-27
- Last updated
- 2019-12-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.