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SOUTH SHORE MEDICAL ASSOCIATES, LLC

Company Details

Name: SOUTH SHORE MEDICAL ASSOCIATES, LLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 08 Aug 2002 (23 years ago)
Entity Number: 2798602
ZIP code: 11758
County: Nassau
Place of Formation: New York
Address: 535 BROADWAY, MASSAPEQUA, NY, United States, 11758

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 535 BROADWAY, MASSAPEQUA, NY, United States, 11758

National Provider Identifier

NPI Number:
1891005609

Authorized Person:

Name:
MRS. DENISE A WEIS
Role:
BILLING MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
6318841107

Filings

Filing Number Date Filed Type Effective Date
021022000772 2002-10-22 AFFIDAVIT OF PUBLICATION 2002-10-22
021022000776 2002-10-22 AFFIDAVIT OF PUBLICATION 2002-10-22
020808000006 2002-08-08 ARTICLES OF ORGANIZATION 2002-08-08

Date of last update: 30 Mar 2025

Sources: New York Secretary of State