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RAVI SUTARIA M.D., P.C.

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Company Details

Name: RAVI SUTARIA M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 18 Apr 2019 (6 years ago)
Entity Number: 5536243
ZIP code: 11755
County: Suffolk
Place of Formation: New York
Address: 5 PHILLIPS LANE, LAKE GROVE, NY, United States, 11755

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 5 PHILLIPS LANE, LAKE GROVE, NY, United States, 11755

National Provider Identifier

NPI Number:
1821799578
Certification Date:
2023-07-28

Authorized Person:

Name:
RAVI BHUPATLAL SUTARIA
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
No
Selected Taxonomy:
207RR0500X - Rheumatology Physician
Is Primary:
Yes

Contacts:

Fax:
3479607402

Filings

Filing Number Date Filed Type Effective Date
190418000030 2019-04-18 CERTIFICATE OF INCORPORATION 2019-04-18

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Date of last update: 23 Mar 2025

Sources: New York Secretary of State