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SOUTHTOWNS INTERNAL MEDICINE, P.C.

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Company Details

Name: SOUTHTOWNS INTERNAL MEDICINE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 09 Sep 2004 (21 years ago)
Entity Number: 3099729
ZIP code: 14127
County: Erie
Place of Formation: New York
Address: 3320 N BENZING RD, ORCHARD PARK, NY, United States, 14127

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
C/O GARY R. NELSON DOS Process Agent 3320 N BENZING RD, ORCHARD PARK, NY, United States, 14127

Chief Executive Officer

Name Role Address
DR GARY R NELSON Chief Executive Officer 62 TRAILS END, GRAND ISLAND, NY, United States, 14072

National Provider Identifier

NPI Number:
1356447270

Authorized Person:

Name:
MR. GARY R NELSON
Role:
DO
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
7168250303

History

Start date End date Type Value
2004-09-09 2006-09-21 Address 3775 SOUTHWESTERN BLVD., STE B, ORCHARD PARK, NY, 14127, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
120928006190 2012-09-28 BIENNIAL STATEMENT 2012-09-01
101001002439 2010-10-01 BIENNIAL STATEMENT 2010-09-01
080829002255 2008-08-29 BIENNIAL STATEMENT 2008-09-01
060921002610 2006-09-21 BIENNIAL STATEMENT 2006-09-01
040909000091 2004-09-09 CERTIFICATE OF INCORPORATION 2004-09-09

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Date of last update: 29 Mar 2025

Sources: New York Secretary of State