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DIPLOMAT MEDICAL GROUP, P.C.

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Company Details

Name: DIPLOMAT MEDICAL GROUP, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 05 May 2015 (10 years ago)
Entity Number: 4753429
ZIP code: 11375
County: Queens
Place of Formation: New York
Address: 111-29 QUEENS BOULEVARD, FOREST HILLS, NY, United States, 11375

Contact Details

Phone +1 718-807-1634

Shares Details

Shares issued 1000

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 111-29 QUEENS BOULEVARD, FOREST HILLS, NY, United States, 11375

National Provider Identifier

NPI Number:
1497469894
Certification Date:
2023-01-10

Authorized Person:

Name:
NARGIZA SOBIROVA
Role:
CREDENTIALING SPECIALIST
Phone:

Taxonomy:

Selected Taxonomy:
207PE0004X - Emergency Medical Services (Emergency Medicine) Physician
Is Primary:
No
Selected Taxonomy:
207V00000X - Obstetrics & Gynecology Physician
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
150505000369 2015-05-05 CERTIFICATE OF INCORPORATION 2015-05-05

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Date of last update: 25 Mar 2025

Sources: New York Secretary of State