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SCOTT FORMAN MD P.C.

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Company Details

Name: SCOTT FORMAN MD P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 04 May 2016 (9 years ago)
Date of dissolution: 21 Jun 2021
Entity Number: 4941131
ZIP code: 10562
County: Westchester
Place of Formation: New York
Address: 93 SPRING VALLEY RD., OSSINING, NY, United States, 10562

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 93 SPRING VALLEY RD., OSSINING, NY, United States, 10562

National Provider Identifier

NPI Number:
1366975690

Authorized Person:

Name:
VERONICA CRUZ
Role:
OFFICE MANAGER
Phone:

Taxonomy:

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

Contacts:

Fax:
9142775735

History

Start date End date Type Value
2016-05-04 2021-06-21 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2016-05-04 2022-02-01 Address 93 SPRING VALLEY RD., OSSINING, NY, 10562, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
220201004513 2021-06-21 CERTIFICATE OF DISSOLUTION-CANCELLATION 2021-06-21
160504000488 2016-05-04 CERTIFICATE OF INCORPORATION 2016-05-04

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Date of last update: 25 Mar 2025

Sources: New York Secretary of State