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COUNTRY WIDE MEDICAL SERVICES, P.C.

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Company Details

Name: COUNTRY WIDE MEDICAL SERVICES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 25 Feb 2015 (10 years ago)
Entity Number: 4716027
ZIP code: 11042
County: Nassau
Place of Formation: New York
Address: ATTN: NOOR KHAN, M.D., 1979 MARCUS AVENUE, STE 210, LAKE SUCCESS, NY, United States, 11042

Shares Details

Shares issued 200

Share Par Value 0.01

Type PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent ATTN: NOOR KHAN, M.D., 1979 MARCUS AVENUE, STE 210, LAKE SUCCESS, NY, United States, 11042

National Provider Identifier

NPI Number:
1598134488

Authorized Person:

Name:
JEFFREY WASHINGTON
Role:
GROUP MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
174400000X - Specialist
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
150225000374 2015-02-25 CERTIFICATE OF INCORPORATION 2015-02-25

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Date of last update: 25 Mar 2025

Sources: New York Secretary of State