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KINGS BAY MEDICAL HEALTH P.C.

Company Details

Name: KINGS BAY MEDICAL HEALTH P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 15 Jun 2015 (10 years ago)
Date of dissolution: 04 May 2020
Entity Number: 4774534
ZIP code: 10029
County: New York
Place of Formation: New York
Address: 2069 2ND AVE, NEW YORK, NY, United States, 10029

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
DMITRY ILYEVSKY MD DOS Process Agent 2069 2ND AVE, NEW YORK, NY, United States, 10029

National Provider Identifier

NPI Number:
1184006850

Authorized Person:

Name:
DMITRY ILYEVSKY
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
200504000231 2020-05-04 CERTIFICATE OF DISSOLUTION 2020-05-04
150615000551 2015-06-15 CERTIFICATE OF INCORPORATION 2015-06-15

Date of last update: 25 Mar 2025

Sources: New York Secretary of State