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General NPI Number Information
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NPI Number | 1861311946
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Entity Type | Organization
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Legal Business Name | MEDENTRA LLC
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 8921 169TH ST APT 6G
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City | JAMAICA
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State | NY
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Zip | 11432-5238
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Country | US
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Telephone | 346-396-1252
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Fax |
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Provider Business Mailing Address
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Address Line | 22210 93RD RD
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City | QUEENS VILLAGE
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State | NY
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Zip | 11428-1936
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Country | US
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Telephone | 346-396-1252
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | LOVELY AKTER
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Credential |
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Telephone | 346-396-1252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332BD1200X
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Taxonomy Name | Dialysis Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number |
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License Number State |
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