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ISLAND PSYCHIATRY, P.C.

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Company Details

Name: ISLAND PSYCHIATRY, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 22 May 2015 (10 years ago)
Entity Number: 4763251
ZIP code: 11776
County: Suffolk
Place of Formation: New York
Address: 55 Nesconset Highway, Port Jefferson Station, NY, United States, 11776

Shares Details

Shares issued 500

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
RANDALL A SOLOMON MD DOS Process Agent 55 Nesconset Highway, Port Jefferson Station, NY, United States, 11776

Chief Executive Officer

Name Role Address
RANDALL A SOLOMON MD Chief Executive Officer 55 NESCONSET HIGHWAY, PORT JEFFERSON STATION, NY, United States, 11776

National Provider Identifier

NPI Number:
1609249754
Certification Date:
2021-02-09

Authorized Person:

Name:
RANDALL SOLOMON
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
No
Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
Yes

Contacts:

Fax:
8885065997

History

Start date End date Type Value
2025-05-01 2025-05-01 Address 55 NESCONSET HIGHWAY, PORT JEFFERSON STATION, NY, 11776, USA (Type of address: Chief Executive Officer)
2025-05-01 2025-05-01 Address 55 NESCONSET HIGHWAY, STE 1, PORT JEFFERSON STATION, NY, 11776, USA (Type of address: Chief Executive Officer)
2024-12-23 2025-05-01 Address 55 NESCONSET HIGHWAY, PORT JEFFERSON STATION, NY, 11776, USA (Type of address: Chief Executive Officer)
2024-12-23 2025-05-01 Shares Share type: NO PAR VALUE, Number of shares: 500, Par value: 0
2024-12-23 2025-05-01 Address 55 Nesconset Highway, Port Jefferson Station, NY, 11776, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
250501046108 2025-05-01 BIENNIAL STATEMENT 2025-05-01
241223001001 2024-12-23 BIENNIAL STATEMENT 2024-12-23
150522000372 2015-05-22 CERTIFICATE OF INCORPORATION 2015-05-22

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Date of last update: 25 Mar 2025

Sources: New York Secretary of State