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NORTH SHORE MEDICAL GROUP, PLLC

Company Details

Name: NORTH SHORE MEDICAL GROUP, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 03 Mar 2020 (5 years ago)
Entity Number: 5720686
ZIP code: 13219
County: Onondaga
Place of Formation: New York
Address: 611 SKYVIEW TERRACE, SYRACUSE, NY, United States, 13219

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 611 SKYVIEW TERRACE, SYRACUSE, NY, United States, 13219

National Provider Identifier

NPI Number:
1487252581
Certification Date:
2022-05-16

Authorized Person:

Name:
JOSHU COPPOLA
Role:
PA
Phone:

Taxonomy:

Selected Taxonomy:
207QA0505X - Adult Medicine Physician
Is Primary:
Yes
Selected Taxonomy:
363AM0700X - Medical Physician Assistant
Is Primary:
No

Contacts:

Fax:
9522092012

History

Start date End date Type Value
2020-03-03 2021-03-11 Address 4437 PACE LANE, CLAY, NY, 13041, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
210323000367 2021-03-23 CERTIFICATE OF PUBLICATION 2021-03-23
210311000290 2021-03-11 CERTIFICATE OF CHANGE 2021-03-11
200303000563 2020-03-03 ARTICLES OF ORGANIZATION 2020-03-03

Date of last update: 23 Mar 2025

Sources: New York Secretary of State