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MOSHOLU MEDICAL GROUP, P.C.

Company Details

Name: MOSHOLU MEDICAL GROUP, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 24 Jun 2014 (11 years ago)
Entity Number: 4597481
ZIP code: 10471
County: Bronx
Place of Formation: New York
Address: 5750 MOSHOLU AVENUE, BRONX, NY, United States, 10471

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THEODORE C. DOCU, M.D. DOS Process Agent 5750 MOSHOLU AVENUE, BRONX, NY, United States, 10471

National Provider Identifier

NPI Number:
1487059515
Certification Date:
2020-07-14

Authorized Person:

Name:
DR. THEODORE COSTA DOCU
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
9145919794

Filings

Filing Number Date Filed Type Effective Date
140624000862 2014-06-24 CERTIFICATE OF INCORPORATION 2014-06-24

Date of last update: 25 Mar 2025

Sources: New York Secretary of State