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GLEN COVE PHYSICAL MEDICINE, P.C.

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Company Details

Name: GLEN COVE PHYSICAL MEDICINE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 29 Aug 2011 (14 years ago)
Entity Number: 4136116
ZIP code: 11542
County: Nassau
Place of Formation: New York
Address: P.O. BOX 561, GLEN COVE, NY, United States, 11542

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent P.O. BOX 561, GLEN COVE, NY, United States, 11542

National Provider Identifier

NPI Number:
1740564087

Authorized Person:

Name:
ERIC S. ROTH
Role:
PC OWNER
Phone:

Taxonomy:

Selected Taxonomy:
111N00000X - Chiropractor
Is Primary:
No
Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
No
Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
Yes

Contacts:

Fax:
5167592117

Filings

Filing Number Date Filed Type Effective Date
110829000535 2011-08-29 CERTIFICATE OF INCORPORATION 2011-08-29

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State