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JACOB H JACOBY MEDICAL, P.C.

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Company Details

Name: JACOB H JACOBY MEDICAL, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 28 Aug 2019 (6 years ago)
Entity Number: 5611599
ZIP code: 10952
County: Rockland
Place of Formation: New York
Address: 46 CONCORD DRIVE, MONSEY, NY, United States, 10952

Contact Details

Phone +1 845-697-0000

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 46 CONCORD DRIVE, MONSEY, NY, United States, 10952

National Provider Identifier

NPI Number:
1316597008

Authorized Person:

Name:
JACOB JACOBY
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
101YA0400X - Addiction (Substance Use Disorder) Counselor
Is Primary:
No
Selected Taxonomy:
103TB0200X - Cognitive & Behavioral Psychologist
Is Primary:
No
Selected Taxonomy:
103TF0000X - Family Psychologist
Is Primary:
No
Selected Taxonomy:
103TC2200X - Clinical Child & Adolescent Psychologist
Is Primary:
Yes

Contacts:

Fax:
7183876429

Filings

Filing Number Date Filed Type Effective Date
190828000053 2019-08-28 CERTIFICATE OF INCORPORATION 2019-08-28

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Date of last update: 23 Mar 2025

Sources: New York Secretary of State