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GREEN ROOM PHYSICAL THERAPY PLLC

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Company Details

Name: GREEN ROOM PHYSICAL THERAPY PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 28 Feb 2017 (8 years ago)
Entity Number: 5093521
ZIP code: 12169
County: Rensselaer
Place of Formation: New York
Address: 88 FIRETOWER ROAD, STEPHENTOWN, NY, United States, 12169

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 88 FIRETOWER ROAD, STEPHENTOWN, NY, United States, 12169

National Provider Identifier

NPI Number:
1083154132
Certification Date:
2025-04-07

Authorized Person:

Name:
DR. ASHLEY BERTORELLI
Role:
OWNER/DOCTOR OF PHYSICAL THERAPY
Phone:

Taxonomy:

Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
No
Selected Taxonomy:
261QP2000X - Physical Therapy Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
5187761070

Filings

Filing Number Date Filed Type Effective Date
200130000591 2020-01-30 CERTIFICATE OF AMENDMENT 2020-01-30
170228000872 2017-02-28 ARTICLES OF ORGANIZATION 2017-02-28

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Date of last update: 24 Mar 2025

Sources: New York Secretary of State