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DARA BRENER, M.D., P.C.

Company Details

Name: DARA BRENER, M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 31 Oct 2011 (14 years ago)
Entity Number: 4159713
ZIP code: 11795
County: Suffolk
Place of Formation: New York
Address: 646 ALWICK AVENUE, WEST ISLIP, NY, United States, 11795

Contact Details

Phone +1 631-331-4403

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
BERNARD A. NATHAN, P.C. DOS Process Agent 646 ALWICK AVENUE, WEST ISLIP, NY, United States, 11795

National Provider Identifier

NPI Number:
1154605152

Authorized Person:

Name:
DR. DARA GAIL BRENER
Role:
M.D., CEO
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
6313311932

Filings

Filing Number Date Filed Type Effective Date
111031000252 2011-10-31 CERTIFICATE OF INCORPORATION 2011-10-31

Date of last update: 26 Mar 2025

Sources: New York Secretary of State