Healthcare Provider Details
I. General information
NPI: 1043157407
Provider Name (Legal Business Name): IDOC INTERNATIONAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/02/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2411 E 4TH ST
BROOKLYN NY
11223-5427
US
IV. Provider business mailing address
2609 E 14TH ST # 287
BROOKLYN NY
11235-3915
US
V. Phone/Fax
- Phone: 718-629-8940
- Fax:
- Phone: 718-629-8940
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DALER
RAKHMONOV
Title or Position: CEO
Credential:
Phone: 718-629-8940