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ANDREA E. NOMBERG, PHYSICIAN, P.C.

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Company Details

Name: ANDREA E. NOMBERG, PHYSICIAN, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 16 Jul 2013 (12 years ago)
Entity Number: 4431654
ZIP code: 11779
County: Suffolk
Place of Formation: New York
Address: 709 HAWKINS AVENUE, RONKONKOMA, NY, United States, 11779

Contact Details

Phone +1 631-588-0880

Phone +1 631-583-3333

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 709 HAWKINS AVENUE, RONKONKOMA, NY, United States, 11779

National Provider Identifier

NPI Number:
1295394120
Certification Date:
2024-02-28

Authorized Person:

Name:
ANDREA NOMBERG
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
130716000574 2013-07-16 CERTIFICATE OF INCORPORATION 2013-07-16

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State