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LIGHTHOUSE MEDICAL REHABILITATION P.C.

Company Details

Name: LIGHTHOUSE MEDICAL REHABILITATION P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 12 Apr 2013 (12 years ago)
Date of dissolution: 10 Feb 2020
Entity Number: 4387402
ZIP code: 11771
County: Nassau
Place of Formation: New York
Address: 969 RIPLEY LANE, OYSTER BAY, NY, United States, 11771

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 969 RIPLEY LANE, OYSTER BAY, NY, United States, 11771

National Provider Identifier

NPI Number:
1710323738

Authorized Person:

Name:
DR. KWAN L. JAKOBSEN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
Yes

Contacts:

Fax:
5162009088

Filings

Filing Number Date Filed Type Effective Date
200210000082 2020-02-10 CERTIFICATE OF DISSOLUTION 2020-02-10
130412000010 2013-04-12 CERTIFICATE OF INCORPORATION 2013-04-12

Date of last update: 26 Mar 2025

Sources: New York Secretary of State