Lic Com, LLC

Primary specialty

Home Delivered MealsTaxonomy code 332U00000X

Legal business name

LIC COM, LLC

Doing business as

Kommissary

Practice address

509 Manida St
Bronx, NY 10474-6821

Phone

(888) 676-2892

Fax

(518) 797-6257

NPI assigned

Jan 13, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ethan Lee

Title

Cfo

Phone

(201) 556-8312

Specialties & licenses 3

Addresses

Other names 1

• Kommissary Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1768262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769040000000",
    "number": "1508724089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 MANIDA ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104746821",
            "telephone_number": "888-676-2892",
            "fax_number": "518-797-6257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 MANIDA ST",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104746821",
            "telephone_number": "888-676-2892",
            "fax_number": "518-797-6257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIC COM, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-13",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "201-556-8312"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "335G00000X",
            "taxonomy_group": "",
            "desc": "Medical Foods Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kommissary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jae Libradilla, PT
• Angela America Libranti, PA
• Belkis Liburd Rodriguez
• Veronica Liburd
• Joseph M Libutan, OTR
• Bernard Spencer Lichtenstein, DDS
• Ralph B Lichtenstein, M.D.
• Amy Lichter, SOCIAL WORKER
• Anna Bluestone Lichtiger, MD
• Rebecca Diane Lichtin, MD

• Home Delivered Meals in Bronx, NY
• Providers in Bronx, NY by specialty
• Home Delivered Meals in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.