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ISLAND NEUROLOGICAL THERAPY, P.C.

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Company Details

Name: ISLAND NEUROLOGICAL THERAPY, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 05 May 2015 (10 years ago)
Entity Number: 4753747
ZIP code: 11758
County: Nassau
Place of Formation: New York
Address: 922 N. BROADWAY, MASSAPEQUA, NY, United States, 11758

Contact Details

Phone +1 516-520-5507

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 922 N. BROADWAY, MASSAPEQUA, NY, United States, 11758

National Provider Identifier

NPI Number:
1710368246
Certification Date:
2023-10-23

Authorized Person:

Name:
DR. BIRENDRA TRIVEDI
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
261QM2500X - Medical Specialty Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
5165205493

Filings

Filing Number Date Filed Type Effective Date
150505000686 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