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FOREFRONT BEHAVIORAL MEDICINE, P.C.

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Company Details

Name: FOREFRONT BEHAVIORAL MEDICINE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 07 Nov 2017 (8 years ago)
Entity Number: 5230618
ZIP code: 10005
County: New York
Place of Formation: New York
Address: 28 LIBERTY STREET, NEW YORK, NY, United States, 10005
Principal Address: 3500 Quakerbridge Road Suite 105, SUITE 112, HAMILTON, NJ, United States, 08619

Contact Details

Phone +1 510-201-0190

Phone +1 866-959-2008

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Agent

Name Role Address
C T CORPORATION SYSTEM Agent 28 LIBERTY STREET, NEW YORK, NY, 10005

DOS Process Agent

Name Role Address
c/o C T CORPORATION SYSTEM DOS Process Agent 28 LIBERTY STREET, NEW YORK, NY, United States, 10005

Chief Executive Officer

Name Role Address
ROB REBAK Chief Executive Officer 200 AMERICAN METRO BLVD, SUITE 112, HAMILTON, NJ, United States, 08619

National Provider Identifier

NPI Number:
1558874586
Certification Date:
2024-10-18

Authorized Person:

Name:
JOSEPH B HOLMGREN
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Fax:
8889722903
Fax:
8885068293

History

Start date End date Type Value
2023-11-21 2023-11-21 Address 200 AMERICAN METRO BLVD, SUITE 112, HAMILTON, NJ, 08619, USA (Type of address: Chief Executive Officer)
2023-11-02 2023-11-21 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2023-11-02 2023-11-02 Address 200 AMERICAN METRO BLVD, SUITE 112, HAMILTON, NJ, 08619, USA (Type of address: Chief Executive Officer)
2023-11-02 2023-11-21 Address 200 AMERICAN METRO BLVD, SUITE 112, HAMILTON, NJ, 08619, USA (Type of address: Chief Executive Officer)
2023-11-02 2023-11-21 Address 122 EAST 42ND STREET, 18TH FLOOR, NEW YORK, NY, 10168, USA (Type of address: Registered Agent)

Filings

Filing Number Date Filed Type Effective Date
231121003263 2023-11-21 CERTIFICATE OF CHANGE BY ENTITY 2023-11-21
231102002458 2023-11-02 BIENNIAL STATEMENT 2023-11-01
211105000096 2021-11-05 BIENNIAL STATEMENT 2021-11-05
SR-112540 2019-11-27 CERTIFICATE OF CHANGE (BY AGENT) 2019-11-27
SR-112539 2019-11-27 CERTIFICATE OF CHANGE (BY AGENT) 2019-11-27

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Date of last update: 24 Mar 2025

Sources: New York Secretary of State