Healthcare Provider Details

I. General information

NPI: 1093653347
Provider Name (Legal Business Name): TRISTATE DME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8804 136TH ST
RICHMOND HILL NY
11418-1921
US

IV. Provider business mailing address

PO BOX 200239
SOUTH OZONE PARK NY
11420-0239
US

V. Phone/Fax

Practice location:
  • Phone: 516-474-6079
  • Fax: 877-539-1653
Mailing address:
  • Phone: 516-474-6079
  • Fax: 877-539-1653

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: NARESH MOOKLALL
Title or Position: OWNER
Credential:
Phone: 917-603-5161