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PARK 62 ORAL FACIAL SURGERY P.C.

Company Details

Name: PARK 62 ORAL FACIAL SURGERY P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 20 Apr 2017 (8 years ago)
Entity Number: 5122646
ZIP code: 10065
County: New York
Place of Formation: New York
Address: 563 PARK AVENUE, NEW YORK, NY, United States, 10065

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 563 PARK AVENUE, NEW YORK, NY, United States, 10065

National Provider Identifier

NPI Number:
1518493717

Authorized Person:

Name:
GREGORY CHOTKOWSKI
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
170420000264 2017-04-20 CERTIFICATE OF INCORPORATION 2017-04-20

Date of last update: 24 Mar 2025

Sources: New York Secretary of State