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CLEMENSEN FAMILY MEDICINE, P.C.

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Company Details

Name: CLEMENSEN FAMILY MEDICINE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 25 Aug 2006 (19 years ago)
Date of dissolution: 05 Dec 2008
Entity Number: 3405039
ZIP code: 14424
County: Ontario
Place of Formation: New York
Address: 475 N. MAIN STREET, CANANDAIGUA, NY, United States, 14424
Principal Address: 181 S MAIN ST, STE 5, CANANDAIGUA, NY, United States, 14424

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 475 N. MAIN STREET, CANANDAIGUA, NY, United States, 14424

Chief Executive Officer

Name Role Address
SCOTT CLEMENSEN Chief Executive Officer 181 S MAIN ST, STE 5, CANANDAIGUA, NY, United States, 14424

National Provider Identifier

NPI Number:
1396947073

Authorized Person:

Name:
DR. SCOTT ERIK CLEMENSEN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
8662694810

Filings

Filing Number Date Filed Type Effective Date
081205000842 2008-12-05 CERTIFICATE OF DISSOLUTION 2008-12-05
080807003165 2008-08-07 BIENNIAL STATEMENT 2008-08-01
060825000192 2006-08-25 CERTIFICATE OF INCORPORATION 2006-08-25

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State