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LIVING WELL NEW YORK MEDICAL P.C.

Company Details

Name: LIVING WELL NEW YORK MEDICAL P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 02 Feb 2015 (10 years ago)
Entity Number: 4703597
ZIP code: 10012
County: New York
Place of Formation: New York
Address: 632 BROADWAY STE 303, NEW YORK, NY, United States, 10012

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 632 BROADWAY STE 303, NEW YORK, NY, United States, 10012

National Provider Identifier

NPI Number:
1972994911

Authorized Person:

Name:
DAN THOMAS
Role:
BILLING MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
111NR0400X - Rehabilitation Chiropractor
Is Primary:
Yes

Contacts:

Fax:
2127771653

Filings

Filing Number Date Filed Type Effective Date
150202000259 2015-02-02 CERTIFICATE OF INCORPORATION 2015-02-02

Date of last update: 25 Mar 2025

Sources: New York Secretary of State