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DIVINITY PHYSICIAN SERVICES, PLLC

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Company Details

Name: DIVINITY PHYSICIAN SERVICES, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 08 Mar 2017 (8 years ago)
Entity Number: 5098667
ZIP code: 10598
County: Westchester
Place of Formation: New York
Address: 3379 CROMPOND ROAD, YORKTOWN HEIGHTS, NY, United States, 10598

DOS Process Agent

Name Role Address
DIVINITY PHYSICIAN SERVICES, PLLC DOS Process Agent 3379 CROMPOND ROAD, YORKTOWN HEIGHTS, NY, United States, 10598

National Provider Identifier

NPI Number:
1962935163
Certification Date:
2023-08-14

Authorized Person:

Name:
DR. RAJESH GUPTA
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
3473294009

Filings

Filing Number Date Filed Type Effective Date
170614000595 2017-06-14 CERTIFICATE OF PUBLICATION 2017-06-14
170308000530 2017-03-08 ARTICLES OF ORGANIZATION 2017-03-08

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Date of last update: 24 Mar 2025

Sources: New York Secretary of State