Provider Demographics
NPI:1891670212
Name:2244 JERICHO RX INC
Entity type:Organization
Organization Name:2244 JERICHO RX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MATAYEV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-995-8710
Mailing Address - Street 1:2244 JERICHO TPKE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-4745
Mailing Address - Country:US
Mailing Address - Phone:347-995-8710
Mailing Address - Fax:347-882-5726
Practice Address - Street 1:2244 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-4745
Practice Address - Country:US
Practice Address - Phone:347-995-8710
Practice Address - Fax:347-882-5726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy