1105 JTP LLC
NPI 1982243788
Pharmacy - Community/Retail Pharmacy in New Hyde Park, NY

Q: What is 1105 Jtp LLC's NPI number?

The NPI number for 1105 Jtp LLC is 1982243788. It was assigned to this organization in the NPPES registry on December 27, 2019. The provider is doing business as genome pharmacy.

Q: What is 1105 Jtp LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Q: When was this NPI record last updated?

The NPPES record for 1105 Jtp LLC was last updated on December 27, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 27, 2019

1105 JERICHO TPKE, NEW HYDE PARK, NY 11040(516) 775-7775 Get Directions Write a Review

NPPES record last updated: December 27, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About 1105 Jtp Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

1105 JTP LLC (NPI 1982243788), doing business as Genome Pharmacy, is a healthcare organization registered as a community/retail pharmacy in New Hyde Park, New York and active in the NPI registry since December 2019. The organization lists Ishbay Shukurov, Owner, as its authorized official.

NPPES Registry Identity

NPI1982243788

Entity TypeOrganization

Primary Taxonomy3336C0003X

Legal Business Name1105 JTP LLC

Location Address1105 JERICHO TPKENew Hyde Park, NY 11040-4603

Mailing Address1105 Jericho TpkeNew Hyde Park, NY 11040-4603

Phone(516) 775-7775

Organization SubpartNo

Authorized OfficialIshbay ShukurovOwner · (516) 775-7775

Enumeration DateDecember 27, 2019

✔ NPI 1982243788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers

Taxonomy Code3336C0003X

Definition

A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

1105 JERICHO TPKE, New Hyde Park, NY 11040

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Other Names 1

Doing Business AsGenome Pharmacy

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHREEMAN PHARMACY INC

Pharmacy (Community/Retail Pharmacy)

1105 JERICHO TPKE
NEW HYDE PARK, NY 11040

Nassau County (516) 775-7775

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is 1105 Jtp LLC's NPI number?

The NPI number for 1105 Jtp LLC is 1982243788. It was assigned to this organization in the NPPES registry on December 27, 2019. The provider is doing business as genome pharmacy.

Where is 1105 Jtp LLC located?

1105 Jtp LLC is located at 1105 Jericho Tpke, New Hyde Park, NY 11040. The listed phone number is (516) 775-7775.

What is 1105 Jtp LLC's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

When was this NPI record last updated?

The NPPES record for 1105 Jtp LLC was last updated on December 27, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.