Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lic Com, LLC

Organization Public Health or Welfare Agency · NPI 1508724089

Lic Com, LLC is a Public Health or Welfare Agency in Bronx, New York. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

509 Manida St
Bronx, NY 10474-6821
Phone: (888) 676-2892
Fax: (518) 797-6257
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Home Delivered Meals (primary) Taxonomy 332U00000X
Public Health or Welfare Agency Taxonomy 251K00000X
Medical Foods Supplier Taxonomy 335G00000X

Record details

NPI number1508724089
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ethan Lee — Cfo · (201) 556-8312
Other names Kommissary
NPI enumeratedJanuary 13, 2026
Last updated in NPPESJanuary 22, 2026
Certification dateJanuary 22, 2026
Mailing address509 Manida St, Bronx, NY 10474-6821

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