LIC COM LLC NPI 1508724089

NPI Information

  • NPI: 1508724089
  • Provider Name: LIC COM, LLC
  • Classification: Home Delivered Meals - 332U00000X
  • Entity Type: Organization
  • Address: 509 MANIDA ST
    BRONX, NY
    ZIP 10474
  • Phone: (888) 676-2892

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NPI Details

LIC COM, LLC is a home delivered meals in Bronx, NY. The provider is home-delivered meals are those services or activities designed to prepare and deliver one or more meals a day to an individual's residence in order to prevent institutionalization, malnutrition, and feelings of isolation. Component services or activities may include the cost of personnel, equipment, and food; assessment of nutritional and dietary needs; nutritional education and counseling; socialization services; and information and referral. LIC COM, LLC NPI is 1508724089. The provider is registered as an organization entity type.

The provider's business location address is:

509 MANIDA ST
BRONX, NY
ZIP 10474-821
Phone: (888) 676-2892
Fax: (518) 797-6257

The provider's authorized official is Ethan Lee .
The authorized official title is Cfo and has the following contact phone number (201) 556-8312.

The enumeration date for this NPI number is 1/13/2026 and was last updated on 1/22/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251K00000XPublic Health or WelfareNo
2335G00000XMedical Foods SupplierNo
3332U00000XHome Delivered MealsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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