OrganizationActiveAccepts Medicare
Myrtle Avenue Trading LLC
NPI 1669995007 · Customized Equipment (DME) · Glendale, NY
Enrolled with Medicare as Dme Supplier - Medical Supply Company · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1669995007
- Entity type
- Organization
- Primary specialty
- Customized Equipment (DME)Suppliers
- Organization subpart
- No
- Authorized official
- Rakhmin Dekhkanov, Member(347) 384-2789
- License
- 2050808-DCA (NY)
Specialties & taxonomies
Suppliers
Profile Score
Established profile(69/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES 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
7611 Myrtle Ave
Glendale, NY 11385-7446
Phone: (347) 384-2789
Fax: (646) 968-9971
Street-level locationGet directions
Mailing address
7611 Myrtle Ave
Glendale, NY 11385-7446
Registry dates
- Enumerated
- 2017-07-18
- Last updated
- 2024-10-02
- Certified
- 2024-10-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.