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SIMPLE NURSE PRACTITIONER IN FAMILY HEALTH P.C.

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Company Details

Name: SIMPLE NURSE PRACTITIONER IN FAMILY HEALTH P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 19 Sep 2019 (6 years ago)
Entity Number: 5624480
ZIP code: 11214
County: Kings
Place of Formation: New York
Address: 2327 83RD STREET, SUITE D, BROOKLYN, NY, United States, 11214

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
SIMPLE NURSE PRACTITIONER IN FAMILY HEALTH P.C. DOS Process Agent 2327 83RD STREET, SUITE D, BROOKLYN, NY, United States, 11214

National Provider Identifier

NPI Number:
1821634130

Authorized Person:

Name:
IRENA HARTELL
Role:
DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
207RC0000X - Cardiovascular Disease Physician
Is Primary:
No
Selected Taxonomy:
207RP1001X - Pulmonary Disease Physician
Is Primary:
No
Selected Taxonomy:
2085R0202X - Diagnostic Radiology Physician
Is Primary:
No
Selected Taxonomy:
364SF0001X - Family Health Clinical Nurse Specialist
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
190919000625 2019-09-19 CERTIFICATE OF INCORPORATION 2019-09-19

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Date of last update: 23 Mar 2025

Sources: New York Secretary of State