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PEDIATRIC PSYCHOLOGY OF NEW YORK, PLLC

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Company Details

Name: PEDIATRIC PSYCHOLOGY OF NEW YORK, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 14 Jan 2011 (14 years ago)
Entity Number: 4042443
ZIP code: 10022
County: Queens
Place of Formation: New York
Address: 425 PARK AVE., NEW YORK, NY, United States, 10022

DOS Process Agent

Name Role Address
MICHAEL J. GRUDBERG DOS Process Agent 425 PARK AVE., NEW YORK, NY, United States, 10022

National Provider Identifier

NPI Number:
1386910347

Authorized Person:

Name:
DR. MARK VINCENT GRUDBERG
Role:
MEMBER
Phone:

Taxonomy:

Selected Taxonomy:
103TC0700X - Clinical Psychologist
Is Primary:
Yes

Contacts:

Fax:
3473446594

Filings

Filing Number Date Filed Type Effective Date
110114000033 2011-01-14 ARTICLES OF ORGANIZATION 2011-01-14

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Date of last update: 27 Mar 2025

Sources: New York Secretary of State