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EXCELCIUM MED GROUP P.C.

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Company Details

Name: EXCELCIUM MED GROUP P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 06 Mar 2007 (18 years ago)
Entity Number: 3485098
ZIP code: 10033
County: New York
Place of Formation: New York
Address: 435 FT. WASHINGTON AVENUE #1C, NEW YORK CITY, NY, United States, 10033
Principal Address: 435 FT. WASHINGTON AVE, APT 1C, NEW YORK, NY, United States, 10033

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
JOSE A GORIS MD Chief Executive Officer APT 1C - 435 FT WASHINGTON AVE, NEW YORK, NY, United States, 10033

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 435 FT. WASHINGTON AVENUE #1C, NEW YORK CITY, NY, United States, 10033

National Provider Identifier

NPI Number:
1902042815

Authorized Person:

Name:
JOSE A GORIS
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207ZP0102X - Anatomic Pathology & Clinical Pathology Physician
Is Primary:
No
Selected Taxonomy:
208D00000X - General Practice Physician
Is Primary:
Yes

Contacts:

Fax:
2129234032

Filings

Filing Number Date Filed Type Effective Date
110909002137 2011-09-09 BIENNIAL STATEMENT 2011-03-01
070306000274 2007-03-06 CERTIFICATE OF INCORPORATION 2007-03-06

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State