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WILLIAM R. BASTA, M.D., PLLC

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Company Details

Name: WILLIAM R. BASTA, M.D., PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 20 Jan 2012 (13 years ago)
Entity Number: 4191214
ZIP code: 11542
County: Nassau
Place of Formation: New York
Address: 3 SCHOOL STREET, SUITE 303, GLEN COVE, NY, United States, 11542

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 3 SCHOOL STREET, SUITE 303, GLEN COVE, NY, United States, 11542

National Provider Identifier

NPI Number:
1982977435

Authorized Person:

Name:
WILLIAM BASTA
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207RC0200X - Critical Care Medicine (Internal Medicine) Physician
Is Primary:
No
Selected Taxonomy:
207RP1001X - Pulmonary Disease Physician
Is Primary:
Yes

Contacts:

Fax:
5166742256

Filings

Filing Number Date Filed Type Effective Date
120120000400 2012-01-20 ARTICLES OF ORGANIZATION 2012-01-20

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State