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CLARK DERMATOLOGY, L.L.C.

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Company Details

Name: CLARK DERMATOLOGY, L.L.C.
Jurisdiction: New York
Legal type: FOREIGN PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 08 May 2015 (10 years ago)
Entity Number: 4755606
ZIP code: 10301
County: Richmond
Place of Formation: New Jersey
Address: 1324 VICTORY BLVD., STATEN ISLAND, NY, United States, 10301

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 1324 VICTORY BLVD., STATEN ISLAND, NY, United States, 10301

National Provider Identifier

NPI Number:
1417316274
Certification Date:
2025-05-05

Authorized Person:

Name:
ALEXANDER DOCTOROFF
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207ND0101X - MOHS-Micrographic Surgery Physician
Is Primary:
No
Selected Taxonomy:
207ND0900X - Dermatopathology Physician
Is Primary:
No
Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
Yes

Contacts:

Fax:
9085127300

Filings

Filing Number Date Filed Type Effective Date
150708000025 2015-07-08 CERTIFICATE OF PUBLICATION 2015-07-08
150508000188 2015-05-08 APPLICATION OF AUTHORITY 2015-05-08

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Date of last update: 25 Mar 2025

Sources: New York Secretary of State