Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

1105 Jtp LLC

Organization Community/Retail Pharmacy · NPI 1982243788

1105 Jtp LLC is a Community/Retail Pharmacy in New Hyde Park, New York. Registered with an NPI since 2019.

In the registry since
2019
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1105 Jericho Tpke
New Hyde Park, NY 11040-4603
Phone: (516) 775-7775
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Retail Pharmacy (primary) Taxonomy 3336C0003X

Record details

NPI number1982243788
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ishbay Shukurov — Owner · (516) 775-7775
Other names Genome Pharmacy
NPI enumeratedDecember 27, 2019
Last updated in NPPESDecember 27, 2019
Certification dateDecember 27, 2019
Mailing address1105 Jericho Tpke, New Hyde Park, NY 11040-4603

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