MEDICARE: ELITE SOLUTIONS ENTERPRISE CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1770415820
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELITE SOLUTIONS ENTERPRISE CORP

Provider Business Mailing Address
First Line	:	12428 QUEENS BLVD APT 3A
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-2796
Country	:	US
Telephone Number	:	917-915-5199
Fax Number	:

Provider Business Practice Location Address
First Line	:	12428 QUEENS BLVD APT 3A
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-2796
Country	:	US
Telephone Number	:	917-915-5199
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SERGEY YAKUBOV
Credential	:
Telephone Number	:	917-915-5199

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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Directions to “ELITE SOLUTIONS ENTERPRISE CORP ” Practice Location

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