OrganizationActive
Lic Com, LLC
NPI 1508724089 · Home Delivered Meals · Bronx, NY
Lic Com, LLC is a Home Delivered Meals organization in Bronx, NY (NPI 1508724089).
Provider details
- NPI number
- 1508724089
- Entity type
- Organization
- Primary specialty
- Home Delivered MealsSuppliers
- Organization subpart
- No
- Authorized official
- Ethan Lee, Cfo(201) 556-8312
Specialties & taxonomies
Suppliers
- Public Health or Welfare Agency251K00000X
Agencies
- Medical Foods Supplier335G00000X
Suppliers
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
509 Manida St
Bronx, NY 10474-6821
Phone: (888) 676-2892
Fax: (518) 797-6257
Street-level locationGet directions
Mailing address
509 Manida St
Bronx, NY 10474-6821
Other names (DBA / former)
- Doing business as
- Kommissary
Registry dates
- Enumerated
- 2026-01-13
- Last updated
- 2026-01-22
- Certified
- 2026-01-22
Frequently asked questions
- What is Lic Com, LLC's NPI number?
- Lic Com, LLC's National Provider Identifier (NPI) is 1508724089, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Lic Com, LLC?
- Lic Com, LLC is classified in the NPPES registry as Home Delivered Meals (Suppliers).
- Where is Lic Com, LLC located?
- Lic Com, LLC's practice location on file with NPPES is 509 Manida St, Bronx, NY 10474-6821.
- What is Lic Com, LLC's phone number?
- The practice phone number listed in the NPPES registry for Lic Com, LLC is (888) 676-2892.
- Who is the authorized official for Lic Com, LLC?
- The authorized official listed on Lic Com, LLC's NPPES record is Ethan Lee, Cfo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Lic Com, LLC's NPI active?
- Yes — Lic Com, LLC's NPI (1508724089) is active in the NPPES registry as of the last update on 2026-01-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.