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STAMBLER MEDICAL P.C.

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Company Details

Name: STAMBLER MEDICAL P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 30 Sep 2019 (6 years ago)
Entity Number: 5630168
ZIP code: 11772
County: Suffolk
Place of Formation: New York
Address: 450 WAVERLY AVE, BLDG 2, SUITE 1, PATCHOGUE, NY, United States, 11772

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
JAY B. STAMBLER DOS Process Agent 450 WAVERLY AVE, BLDG 2, SUITE 1, PATCHOGUE, NY, United States, 11772

National Provider Identifier

NPI Number:
1578194783
Certification Date:
2020-01-28

Authorized Person:

Name:
SHAZAD ZEB
Role:
BILLER / OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
6315695229

Filings

Filing Number Date Filed Type Effective Date
190930000883 2019-09-30 CERTIFICATE OF INCORPORATION 2019-09-30

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Date of last update: 23 Mar 2025

Sources: New York Secretary of State