Healthcare Provider Details

I. General information

NPI: 1225995830
Provider Name (Legal Business Name): VITALCARE ESSENTIAL SUPPLIES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

193 HORTON AVE STE 1
LYNBROOK NY
11563-2305
US

IV. Provider business mailing address

193 HORTON AVE STE 1
LYNBROOK NY
11563-2305
US

V. Phone/Fax

Practice location:
  • Phone: 646-567-8371
  • Fax:
Mailing address:
  • Phone: 646-567-8371
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: SYED SHAH
Title or Position: PRESIDENT
Credential:
Phone: 646-567-8371