Provider Demographics
NPI:1417849274
Name:ISKHAKOV, ILYA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ILYA
Middle Name:
Last Name:ISKHAKOV
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:11559-1606
Mailing Address - Country:US
Mailing Address - Phone:516-540-2003
Mailing Address - Fax:
Practice Address - Street 1:546 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2127
Practice Address - Country:US
Practice Address - Phone:516-730-8200
Practice Address - Fax:516-730-8202
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-16
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist