Healthcare Provider Details

I. General information

NPI: 1376458372
Provider Name (Legal Business Name): EASYLIFE LAB & SUPPLIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1659 W 4TH ST # 2F
BROOKLYN NY
11223-1541
US

IV. Provider business mailing address

1659 W 4TH ST # 2F
BROOKLYN NY
11223-1541
US

V. Phone/Fax

Practice location:
  • Phone: 332-786-3731
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: THOMAS EBERT
Title or Position: FOUNDER
Credential:
Phone: 332-786-3731