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JESSICA WOOD PEDIATRIC NURSE PRACTITIONER PLLC

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Company Details

Name: JESSICA WOOD PEDIATRIC NURSE PRACTITIONER PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 23 Jul 2019 (6 years ago)
Entity Number: 5591866
ZIP code: 11934
County: Suffolk
Place of Formation: New York
Address: 14 BOISENBERRY LANE, CENTER MORICHES, NY, United States, 11934

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 14 BOISENBERRY LANE, CENTER MORICHES, NY, United States, 11934

National Provider Identifier

NPI Number:
1114578416
Certification Date:
2025-04-24

Authorized Person:

Name:
JESSICA WOOD
Role:
NURSE PRACTITIONER
Phone:

Taxonomy:

Selected Taxonomy:
363LP0200X - Pediatric Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
6316296762

Filings

Filing Number Date Filed Type Effective Date
190723000799 2019-07-23 ARTICLES OF ORGANIZATION 2019-07-23

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Date of last update: 23 Mar 2025

Sources: New York Secretary of State