Healthcare Provider Details

I. General information

NPI: 1215865803
Provider Name (Legal Business Name): AVANTEX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

158 ETHEL ST
VALLEY STREAM NY
11580-3145
US

IV. Provider business mailing address

158 ETHEL ST
VALLEY STREAM NY
11580-3145
US

V. Phone/Fax

Practice location:
  • Phone: 363-867-1993
  • Fax:
Mailing address:
  • Phone: 363-867-1993
  • 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: MR. SHAFIQ UZ ZAMAN
Title or Position: MD
Credential:
Phone: 363-867-1993