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MICHAEL DEROSA N.P.-ADULT HEALTH, P.C.

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Company Details

Name: MICHAEL DEROSA N.P.-ADULT HEALTH, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 24 Dec 2013 (12 years ago)
Entity Number: 4504914
ZIP code: 11780
County: Suffolk
Place of Formation: New York
Address: 4 BRASSWOOD ROAD, ST. JAMES, NY, United States, 11780

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
MICHAEL DEROSA DOS Process Agent 4 BRASSWOOD ROAD, ST. JAMES, NY, United States, 11780

National Provider Identifier

NPI Number:
1831817824
Certification Date:
2022-08-16

Authorized Person:

Name:
MICHAEL DEROSA
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
363LA2200X - Adult Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
131224000155 2013-12-24 CERTIFICATE OF INCORPORATION 2013-12-24

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State