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JACQUELINE M. SPENCER, D.O., P.C.

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Company Details

Name: JACQUELINE M. SPENCER, D.O., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 28 Sep 2006 (19 years ago)
Entity Number: 3418533
ZIP code: 11703
County: Suffolk
Place of Formation: New York
Address: 1452 DEER PARK AVENUE, N BABYLON, NY, United States, 11703

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
JACQUELINE M SPENCER DOS Process Agent 1452 DEER PARK AVENUE, N BABYLON, NY, United States, 11703

Chief Executive Officer

Name Role Address
JACQUELINE M SPENCER Chief Executive Officer 1452 DEER PARK AVENUE, N BABYLON, NY, United States, 11703

National Provider Identifier

NPI Number:
1386732774

Authorized Person:

Name:
DR. JACQUELINE M SPENCER
Role:
PRESIDENT
Phone:

Taxonomy:

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

Contacts:

Fax:
3152952125
Fax:
6312548503

History

Start date End date Type Value
2006-09-28 2008-09-04 Address ATTN: PRESIDENT, 93 PACE DRIVE SOUTH, WEST ISLIP, NY, 11795, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
080904002638 2008-09-04 BIENNIAL STATEMENT 2008-09-01
060928000798 2006-09-28 CERTIFICATE OF INCORPORATION 2006-09-28

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State