# LONG ISLAND PHARMACY CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285335976
- **Authorized official:** ELONA DAVIDOVA (OWNER)
- **Authorized official phone:** (516) 218-2654

## Contact information

- **Practice address:** 1163A BROADWAY, HEWLETT, NY 11557-2321
- **Practice address phone:** (516) 218-2654
- **Practice address fax:** (516) 218-2655
- **Mailing address:** 1163A BROADWAY, HEWLETT, NY 11557-2321
- **Mailing address phone:** (516) 218-2654
- **Mailing address fax:** (516) 218-2655

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 03/10/2023
- **Last updated:** 11/03/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 040121 | STATE BOARD | NY |