Healthcare Provider Details

I. General information

NPI: 1205358355
Provider Name (Legal Business Name): JLGJ TRADING CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2017
Last Update Date: 07/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 E BETHPAGE RD STE 400
PLAINVIEW NY
11803-4214
US

IV. Provider business mailing address

PO BOX 607
PLAINVIEW NY
11803-0019
US

V. Phone/Fax

Practice location:
  • Phone: 516-752-7036
  • Fax: 516-454-7663
Mailing address:
  • Phone: 516-752-7036
  • Fax: 516-454-7663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. JODI LEIGH TOCH
Title or Position: PRESIDENT
Credential:
Phone: 516-752-7036