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GRAND CONCOURSE HEALTH WELLNESS MEDICAL, P.C.

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Company Details

Name: GRAND CONCOURSE HEALTH WELLNESS MEDICAL, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 05 Jul 2012 (13 years ago)
Date of dissolution: 05 Jul 2017
Entity Number: 4266908
ZIP code: 10029
County: New York
Place of Formation: New York
Address: 2069 2ND AVE., NEW YORK, NY, United States, 10029

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 2069 2ND AVE., NEW YORK, NY, United States, 10029

National Provider Identifier

NPI Number:
1811241631

Authorized Person:

Name:
DMITRY ILYEVSKY
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
7182200489

History

Start date End date Type Value
2012-07-05 2014-01-07 Address 2336 GRAND CONCOURSE, BRONX, NY, 10458, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
170705000123 2017-07-05 CERTIFICATE OF DISSOLUTION 2017-07-05
140107000856 2014-01-07 CERTIFICATE OF CHANGE 2014-01-07
120705000102 2012-07-05 CERTIFICATE OF INCORPORATION 2012-07-05

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State