Search icon

NERLIGE BASAVARAJU PHYSICIAN, P.C.

Company Details

Name: NERLIGE BASAVARAJU PHYSICIAN, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 14 Apr 2017 (8 years ago)
Entity Number: 5119854
ZIP code: 11576
County: Nassau
Place of Formation: New York
Address: 378 ELM DRIVE, ROSLYN, NY, United States, 11576

Contact Details

Phone +1 516-713-4465

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
NERLIGE BASAVARAJU DOS Process Agent 378 ELM DRIVE, ROSLYN, NY, United States, 11576

National Provider Identifier

NPI Number:
1427576370

Authorized Person:

Name:
DR. NERLIGE BASAVARAJU
Role:
CEO
Phone:

Taxonomy:

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

Contacts:

Filings

Filing Number Date Filed Type Effective Date
170414000140 2017-04-14 CERTIFICATE OF INCORPORATION 2017-04-14

Date of last update: 24 Mar 2025

Sources: New York Secretary of State