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CENTRAL BROOKLYN MEDICAL GROUP, LLC

Company Details

Name: CENTRAL BROOKLYN MEDICAL GROUP, LLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 23 Oct 1997 (28 years ago)
Entity Number: 2192623
ZIP code: 10462
County: Kings
Place of Formation: New York
Address: 1423 GLOVER STREET, BRONX, NY, United States, 10462

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 1423 GLOVER STREET, BRONX, NY, United States, 10462

National Provider Identifier

NPI Number:
1821414780

Authorized Person:

Name:
DR. LESLY KERNISANT
Role:
EXECUTIVE DIRECTOR OF CLINICAL PRAC
Phone:

Taxonomy:

Selected Taxonomy:
302R00000X - Health Maintenance Organization
Is Primary:
Yes

Contacts:

Fax:
7184033548

Form 5500 Series

Employer Identification Number (EIN):
112937992
Plan Year:
2013
Number Of Participants:
532
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
461
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
507
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
507
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
395
Sponsors Telephone Number:

History

Start date End date Type Value
1997-10-23 2008-01-25 Address ATTN: MARTIN J. FRIEDMAN, ESQ, 260 MADISON AVENUE, 18TH FLOOR, NEW YORK, NY, 10016, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
080125001115 2008-01-25 CERTIFICATE OF CHANGE 2008-01-25
971023000606 1997-10-23 ARTICLES OF ORGANIZATION 1997-10-23

Date of last update: 31 Mar 2025

Sources: New York Secretary of State