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EARLENE C. SIEBOLD, M.D., P.C.

Company Details

Name: EARLENE C. SIEBOLD, M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 29 May 2015 (10 years ago)
Entity Number: 4766424
ZIP code: 14618
County: Monroe
Place of Formation: New York
Address: 880 #A WESTFALL ROAD, ROCHESTER, NY, United States, 14618

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 880 #A WESTFALL ROAD, ROCHESTER, NY, United States, 14618

National Provider Identifier

NPI Number:
1215312160
Certification Date:
2024-06-28

Authorized Person:

Name:
DR. EARLENE C SIEBOLD
Role:
PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
207W00000X - Ophthalmology Physician
Is Primary:
Yes

Contacts:

Fax:
5854878250

Filings

Filing Number Date Filed Type Effective Date
150529000525 2015-05-29 CERTIFICATE OF INCORPORATION 2015-05-29

USAspending Awards / Financial Assistance

Date:
2020-05-02
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
9000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00

Date of last update: 25 Mar 2025

Sources: New York Secretary of State