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1110 PENNSYLVANIA AVENUE MEDICAL PLLC

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Company Details

Name: 1110 PENNSYLVANIA AVENUE MEDICAL PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 26 Sep 2016 (9 years ago)
Entity Number: 5013798
ZIP code: 11207
County: Kings
Place of Formation: New York
Address: 1110 PENNSYLVANIA AVENUE, #5, BROOKLYN, NY, United States, 11207

Contact Details

Phone +1 718-272-2272

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 1110 PENNSYLVANIA AVENUE, #5, BROOKLYN, NY, United States, 11207

National Provider Identifier

NPI Number:
1730638115

Authorized Person:

Name:
DR. JACQUELINE STOREY
Role:
PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
261QU0200X - Urgent Care Clinic/Center
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
160926000185 2016-09-26 ARTICLES OF ORGANIZATION 2016-09-26

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Date of last update: 24 Mar 2025

Sources: New York Secretary of State