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NYC MEDICAL DOCTOR P.C.

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Company Details

Name: NYC MEDICAL DOCTOR P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 25 Mar 2011 (14 years ago)
Entity Number: 4072617
ZIP code: 11694
County: Kings
Place of Formation: New York
Address: 114-32 ROCKAWAY BEACH BLVD., ROCKAWAY PARK, NY, United States, 11694

Contact Details

Phone +1 347-689-8880

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 114-32 ROCKAWAY BEACH BLVD., ROCKAWAY PARK, NY, United States, 11694

National Provider Identifier

NPI Number:
1831489798
Certification Date:
2025-03-07

Authorized Person:

Name:
ILYA KLEYN
Role:
M.D.
Phone:

Taxonomy:

Selected Taxonomy:
207RG0300X - Geriatric Medicine (Internal Medicine) Physician
Is Primary:
Yes

Contacts:

Fax:
3476898860

Filings

Filing Number Date Filed Type Effective Date
110325000094 2011-03-25 CERTIFICATE OF INCORPORATION 2011-03-25

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Date of last update: 27 Mar 2025

Sources: New York Secretary of State