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ISLAND PHYSIATRY, P.C.

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Company Details

Name: ISLAND PHYSIATRY, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 12 Jul 2005 (20 years ago)
Date of dissolution: 28 Jan 2013
Entity Number: 3229278
ZIP code: 11746
County: Suffolk
Place of Formation: New York
Address: 2 BLACK OAK COURT, DIX HILLS, NY, United States, 11746
Principal Address: 2 BLACK OAK CT., DIX HILLS, NY, United States, 11746

Shares Details

Shares issued 100

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 2 BLACK OAK COURT, DIX HILLS, NY, United States, 11746

Chief Executive Officer

Name Role Address
SAM SONG Chief Executive Officer 2 BLACK OAK CT., DIX HILLS, NY, United States, 11746

National Provider Identifier

NPI Number:
1619179744

Authorized Person:

Name:
DR. SAM SONG
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
130128000778 2013-01-28 CERTIFICATE OF DISSOLUTION 2013-01-28
110822002489 2011-08-22 BIENNIAL STATEMENT 2011-07-01
090708003015 2009-07-08 BIENNIAL STATEMENT 2009-07-01
070730002116 2007-07-30 BIENNIAL STATEMENT 2007-07-01
050712000084 2005-07-12 CERTIFICATE OF INCORPORATION 2005-07-12

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Date of last update: 29 Mar 2025

Sources: New York Secretary of State