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THE LAKE MEDICAL SERVICES P.C.

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Company Details

Name: THE LAKE MEDICAL SERVICES P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 22 Oct 2013 (12 years ago)
Entity Number: 4476053
ZIP code: 11743
County: Suffolk
Place of Formation: New York
Address: 171 LAKE ROAD, APT. 1, HUNTINGTON, NY, United States, 11743

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
FREDDY DESORMEAUX DOS Process Agent 171 LAKE ROAD, APT. 1, HUNTINGTON, NY, United States, 11743

Unique Entity ID

Unique Entity ID:
W2PBEKBKZGR2
CAGE Code:
9KQE1
UEI Expiration Date:
2024-05-14

Business Information

Division Name:
THE LAKE MEDICAL SERVICES PC
Activation Date:
2023-05-26
Initial Registration Date:
2023-01-30

National Provider Identifier

NPI Number:
1538575857

Authorized Person:

Name:
DR. FREDDY DESORMEAUX
Role:
M.D.
Phone:

Taxonomy:

Selected Taxonomy:
261QM2500X - Medical Specialty Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
9143572489

History

Start date End date Type Value
2013-10-22 2022-03-10 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
131022000358 2013-10-22 CERTIFICATE OF INCORPORATION 2013-10-22

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State