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BROOKLYN AVENUE MEDICAL, PLLC

Company Details

Name: BROOKLYN AVENUE MEDICAL, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 08 Jul 2014 (11 years ago)
Entity Number: 4603077
ZIP code: 11228
County: Kings
Place of Formation: New York
Address: 7014 13TH AVENUE, SUITE 202, BROOKLYN, NY, United States, 11228

Contact Details

Phone +1 718-498-7888

DOS Process Agent

Name Role Address
UNITED STATES CORPORATION AGENTS, INC. DOS Process Agent 7014 13TH AVENUE, SUITE 202, BROOKLYN, NY, United States, 11228

National Provider Identifier

NPI Number:
1942686951

Authorized Person:

Name:
DR. SHELBY KEVIN SAMUEL
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
207L00000X - Anesthesiology Physician
Is Primary:
Yes

Contacts:

Fax:
7186047890

Filings

Filing Number Date Filed Type Effective Date
140708000168 2014-07-08 ARTICLES OF ORGANIZATION 2014-07-08

Date of last update: 25 Mar 2025

Sources: New York Secretary of State