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L.I. PRO PHYSICAL THERAPY P.C.

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Company Details

Name: L.I. PRO PHYSICAL THERAPY P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 19 Dec 2012 (13 years ago)
Entity Number: 4335517
ZIP code: 11795
County: Suffolk
Place of Formation: New York
Address: 11 CANBY CT., WEST ISLIP, NY, United States, 11795
Principal Address: 11 CANBY COURT, WEST ISLIP, NY, United States, 1795

Contact Details

Phone +1 631-482-8870

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
JUSTIN A. MINERVA Chief Executive Officer 11 CANBY COURT, WEST ISLIP, NY, United States, 11795

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 11 CANBY CT., WEST ISLIP, NY, United States, 11795

National Provider Identifier

NPI Number:
1104164656

Authorized Person:

Name:
DR. JUSTIN ANDREW MINERVA
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Filings

Filing Number Date Filed Type Effective Date
141219006531 2014-12-19 BIENNIAL STATEMENT 2014-12-01
121219001046 2012-12-19 CERTIFICATE OF INCORPORATION 2012-12-19

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State