NPI 1508724089

Lic Com, LLC

Organisation Home Delivered Meals Bronx, NY

Practice location

Address: 509 Manida St, Bronx, NY 10474-6821
Phone: (888) 676-2892
Fax: (518) 797-6257

Authorised official

Name: Ethan Lee
Title: Cfo
Phone: (201) 556-8312

Registered specialties (3)

Home Delivered Meals Primary

Suppliers Taxonomy 332U00000X

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Public Health or Welfare Agency

Agencies Taxonomy 251K00000X

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Medical Foods Supplier

Suppliers Taxonomy 335G00000X

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Registry record

NPI: 1508724089
Entity type: Organization
NPI issued: 13 Jan 2026
Record last updated: 22 Jan 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.