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LIGHTHOUSE PHYSICAL THERAPY P.C.

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Company Details

Name: LIGHTHOUSE PHYSICAL THERAPY P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 11 Aug 2011 (14 years ago)
Entity Number: 4129232
ZIP code: 11727
County: Suffolk
Place of Formation: New York
Address: 2 WALTON WAY, CORAM, NY, United States, 11727
Principal Address: 60 NORTH COUNTRY ROAD, SUITE 104, PORT JEFFERSON, NY, United States, 11777

Shares Details

Shares issued 200

Share Par Value 0.001

Type PAR VALUE

DOS Process Agent

Name Role Address
JENNIFER NICODEMO-CAPRA DOS Process Agent 2 WALTON WAY, CORAM, NY, United States, 11727

Chief Executive Officer

Name Role Address
JENNIFER NICODEMO-CAPRA Chief Executive Officer 2 WALTON WAY, CORAM, NY, United States, 11727

National Provider Identifier

NPI Number:
1265718332

Authorized Person:

Name:
MRS. JENNIFER NICODEMO-CAPRA
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
Yes

Contacts:

Fax:
6313310320

Filings

Filing Number Date Filed Type Effective Date
130809006378 2013-08-09 BIENNIAL STATEMENT 2013-08-01
110811000047 2011-08-11 CERTIFICATE OF INCORPORATION 2011-08-11

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State