Healthcare Provider Details

I. General information

NPI: 1093628224
Provider Name (Legal Business Name): DOR DUREABLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82-01 BS 251ST
BELLEROSE NY
11426
US

IV. Provider business mailing address

82-01 BS 251ST
BELLEROSE NY
11426
US

V. Phone/Fax

Practice location:
  • Phone: 267-694-8393
  • Fax:
Mailing address:
  • Phone: 267-694-8393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number StateNULL

VIII. Authorized Official

Name: JUDEX DOR
Title or Position: OWNER
Credential:
Phone: 267-694-8393