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GREAT WESTERN PHYSICAL THERAPY P.C.

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Company Details

Name: GREAT WESTERN PHYSICAL THERAPY P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 28 Oct 2019 (6 years ago)
Entity Number: 5645634
ZIP code: 11106
County: Queens
Place of Formation: New York
Address: 31-75 29TH STREET, APT. A-7, ASTORIA, NY, United States, 11106

Contact Details

Phone +1 929-340-1606

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 31-75 29TH STREET, APT. A-7, ASTORIA, NY, United States, 11106

National Provider Identifier

NPI Number:
1174162440
Certification Date:
2020-01-03

Authorized Person:

Name:
DR. MARK DAVYDOV
Role:
PHYSICAL THERAPIST
Phone:

Taxonomy:

Selected Taxonomy:
261QP2000X - Physical Therapy Clinic/Center
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
191028000705 2019-10-28 CERTIFICATE OF INCORPORATION 2019-10-28

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Date of last update: 23 Mar 2025

Sources: New York Secretary of State