Healthcare Provider Details

I. General information

NPI: 1033737093
Provider Name (Legal Business Name): DURABLE HEALTH MEDICAL SUPPLY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2020
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25220 NORTHERN BLVD # E
LITTLE NECK NY
11362-1300
US

IV. Provider business mailing address

25220 NORTHERN BLVD # E
LITTLE NECK NY
11362-1300
US

V. Phone/Fax

Practice location:
  • Phone: 917-423-8539
  • Fax: 917-423-8540
Mailing address:
  • Phone: 917-423-8539
  • Fax: 917-423-8540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332BD1200X
TaxonomyDialysis Equipment & Supplies (DME)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. HENRY K LEE
Title or Position: MANAGING MEMBER
Credential:
Phone: 917-423-8539