OrganizationActive
1105 Jtp LLC
NPI 1982243788 · Community/Retail Pharmacy · New Hyde Park, NY
1105 Jtp LLC is a Community/Retail Pharmacy organization in New Hyde Park, NY (NPI 1982243788).
Provider details
- NPI number
- 1982243788
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Ishbay Shukurov, Owner(516) 775-7775
Specialties & taxonomies
Suppliers
Profile Score
Established profile(65/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1105 Jericho Tpke
New Hyde Park, NY 11040-4603
Phone: (516) 775-7775
Street-level locationGet directions
Mailing address
1105 Jericho Tpke
New Hyde Park, NY 11040-4603
Other names (DBA / former)
- Doing business as
- Genome Pharmacy
Registry dates
- Enumerated
- 2019-12-27
- Last updated
- 2019-12-27
- Certified
- 2019-12-27
Frequently asked questions
- What is 1105 Jtp LLC's NPI number?
- 1105 Jtp LLC's National Provider Identifier (NPI) is 1982243788, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is 1105 Jtp LLC?
- 1105 Jtp LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is 1105 Jtp LLC located?
- 1105 Jtp LLC's practice location on file with NPPES is 1105 Jericho Tpke, New Hyde Park, NY 11040-4603.
- What is 1105 Jtp LLC's phone number?
- The practice phone number listed in the NPPES registry for 1105 Jtp LLC is (516) 775-7775.
- Who is the authorized official for 1105 Jtp LLC?
- The authorized official listed on 1105 Jtp LLC's NPPES record is Ishbay Shukurov, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is 1105 Jtp LLC's NPI active?
- Yes — 1105 Jtp LLC's NPI (1982243788) is active in the NPPES registry as of the last update on 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.