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LE-BEN WAN MD PHD, P.C.

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Company Details

Name: LE-BEN WAN MD PHD, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 19 Jul 2017 (8 years ago)
Entity Number: 5172630
ZIP code: 11101
County: Queens
Place of Formation: New York
Address: 4402 23RD STREET, STE 504, LONG ISLAND CITY, NY, United States, 11101

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 4402 23RD STREET, STE 504, LONG ISLAND CITY, NY, United States, 11101

National Provider Identifier

NPI Number:
1750808051

Authorized Person:

Name:
LE-BEN WAN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
170719000495 2017-07-19 CERTIFICATE OF INCORPORATION 2017-07-19

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Date of last update: 24 Mar 2025

Sources: New York Secretary of State