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EMPIRE STATE MEDICAL P.C.

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Company Details

Name: EMPIRE STATE MEDICAL P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 19 Feb 2013 (12 years ago)
Entity Number: 4361686
ZIP code: 11212
County: Kings
Place of Formation: New York
Address: 1220 EAST NEW YORK AVENUE, BROOKLYN, NY, United States, 11212

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 1220 EAST NEW YORK AVENUE, BROOKLYN, NY, United States, 11212

National Provider Identifier

NPI Number:
1952177057
Certification Date:
2023-11-29

Authorized Person:

Name:
DR. SAMUEL THEAGENE
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
208VP0014X - Interventional Pain Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
3478261917
Fax:
9297554044

Filings

Filing Number Date Filed Type Effective Date
180126000352 2018-01-26 ANNULMENT OF DISSOLUTION 2018-01-26
DP-2230245 2016-10-26 DISSOLUTION BY PROCLAMATION 2016-10-26
130219000756 2013-02-19 CERTIFICATE OF INCORPORATION 2013-02-19

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State