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JERRY CHIN D.O. P.C.

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Company Details

Name: JERRY CHIN D.O. P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 12 Oct 2007 (18 years ago)
Entity Number: 3579274
ZIP code: 11782
County: Suffolk
Place of Formation: New York
Address: 3 NANCY DRIVE, SAYVILLE, NY, United States, 11782

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
JERRY CHIN Chief Executive Officer 3 NANCY DRIVE, SAYVILLE, NY, United States, 11782

DOS Process Agent

Name Role Address
JERRY CHIN D.O. P.C. DOS Process Agent 3 NANCY DRIVE, SAYVILLE, NY, United States, 11782

National Provider Identifier

NPI Number:
1346429701

Authorized Person:

Name:
DR. JERRY CHIN
Role:
PRESIDENT
Phone:

Taxonomy:

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

Contacts:

Fax:
6315179547

History

Start date End date Type Value
2009-10-09 2020-01-07 Address 99 BEAVER DAM RD, ISLIP, NY, 11751, USA (Type of address: Chief Executive Officer)
2009-10-09 2020-01-07 Address 99 BEAVER DAM RD, ISLIP, NY, 11751, USA (Type of address: Principal Executive Office)
2007-10-12 2020-01-07 Address 99 BEAVER DAM ROAD, ISLIP, NY, 11751, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
200107060593 2020-01-07 BIENNIAL STATEMENT 2019-10-01
171010006563 2017-10-10 BIENNIAL STATEMENT 2017-10-01
131101006172 2013-11-01 BIENNIAL STATEMENT 2013-10-01
111102002435 2011-11-02 BIENNIAL STATEMENT 2011-10-01
091009002331 2009-10-09 BIENNIAL STATEMENT 2009-10-01

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State