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SKIN SPECIALISTS OF THE CAPITAL REGION, PLLC

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Company Details

Name: SKIN SPECIALISTS OF THE CAPITAL REGION, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 02 Jan 2004 (21 years ago)
Entity Number: 2994506
ZIP code: 12203
County: Albany
Place of Formation: New York
Address: 264 WASHINGTON AVENUE EXT, ALBANY, NY, United States, 12203

DOS Process Agent

Name Role Address
SKIN SPECIALISTS OF THE CAPITAL REGION, PLLC DOS Process Agent 264 WASHINGTON AVENUE EXT, ALBANY, NY, United States, 12203

National Provider Identifier

NPI Number:
1346437092
Certification Date:
2022-06-15

Authorized Person:

Name:
CHRISTY ARSENAULT
Role:
PRACTICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207ND0101X - MOHS-Micrographic Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
5183621348
Fax:
5187088749

Form 5500 Series

Employer Identification Number (EIN):
200512709
Plan Year:
2023
Number Of Participants:
43
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
40
Sponsors Telephone Number:

History

Start date End date Type Value
2022-04-12 2024-09-11 Address 264 WASHINGTON AVENUE EXT, SUITE 201, ALBANY, NY, 12203, USA (Type of address: Service of Process)
2014-08-13 2022-04-12 Address 264 WASHINGTON AVENUE EXT, SUITE 201, ALBANY, NY, 12203, USA (Type of address: Service of Process)
2013-09-09 2022-04-12 Name DERMATOLOGIC SURGERY OF ALBANY, PLLC
2010-02-12 2014-08-13 Address 2 CORPORATE PLAZA, ALBANY, NY, 12203, USA (Type of address: Service of Process)
2004-01-02 2013-09-09 Name MICHAEL J. MULVANEY, MD, PLLC

Filings

Filing Number Date Filed Type Effective Date
240911000199 2024-09-11 BIENNIAL STATEMENT 2024-09-11
220412000327 2022-03-29 CERTIFICATE OF AMENDMENT 2022-03-29
140813000491 2014-08-13 CERTIFICATE OF CHANGE 2014-08-13
140708002324 2014-07-08 BIENNIAL STATEMENT 2014-01-01
130909000165 2013-09-09 CERTIFICATE OF AMENDMENT 2013-09-09

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Date of last update: 29 Mar 2025

Sources: New York Secretary of State