MEDICARE: LIBERTY DURABLE MEDICAL EQUIPMENT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1396698478
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIBERTY DURABLE MEDICAL EQUIPMENT

Provider Business Mailing Address
First Line	:	27 SKILLMAN AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-5109
Country	:	US
Telephone Number	:	201-683-1280
Fax Number	:

Provider Business Practice Location Address
First Line	:	27 SKILLMAN AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-5109
Country	:	US
Telephone Number	:	201-683-1280
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FAIZAN KHAN
Credential	:
Telephone Number	:	201-683-1280

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	03/05/2026

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