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MAXWELL 58 MEDICAL, P.C.

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Company Details

Name: MAXWELL 58 MEDICAL, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 14 Apr 2017 (8 years ago)
Entity Number: 5119979
ZIP code: 10016
County: New York
Place of Formation: New York
Address: 16 E 40TH STREET, NEW YORK, NY, United States, 10016

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 16 E 40TH STREET, NEW YORK, NY, United States, 10016

National Provider Identifier

NPI Number:
1578099933
Certification Date:
2024-05-23

Authorized Person:

Name:
THANIA LOUISOR
Role:
INSURANCE DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
111N00000X - Chiropractor
Is Primary:
No
Selected Taxonomy:
171100000X - Acupuncturist
Is Primary:
No
Selected Taxonomy:
2081S0010X - Sports Medicine (Physical Medicine & Rehabilitation) Physician
Is Primary:
No
Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
170414000320 2017-04-14 CERTIFICATE OF INCORPORATION 2017-04-14

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Date of last update: 24 Mar 2025

Sources: New York Secretary of State