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MAT MEDICAL ASSOCIATES, P.C.

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Company Details

Name: MAT MEDICAL ASSOCIATES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 09 Apr 2020 (5 years ago)
Entity Number: 5736437
ZIP code: 11764
County: Suffolk
Place of Formation: New York
Address: 565 ROUTE 25A, SUITE 4, MILLER PLACE, NY, United States, 11764

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 565 ROUTE 25A, SUITE 4, MILLER PLACE, NY, United States, 11764

National Provider Identifier

NPI Number:
1891318754
Certification Date:
2020-09-08

Authorized Person:

Name:
DR. DAVID M MARGULIES
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207P00000X - Emergency Medicine Physician
Is Primary:
No
Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
No
Selected Taxonomy:
2084P0802X - Addiction Psychiatry Physician
Is Primary:
No
Selected Taxonomy:
2084P0804X - Child & Adolescent Psychiatry Physician
Is Primary:
No
Selected Taxonomy:
208D00000X - General Practice Physician
Is Primary:
Yes

Contacts:

Fax:
8339790963

History

Start date End date Type Value
2020-09-04 2025-05-21 Address 565 ROUTE 25A, SUITE 4, MILLER PLACE, NY, 11764, USA (Type of address: Service of Process)
2020-04-09 2020-09-04 Address 40 VARSITY BOULEVARD, EAST SETAUKET, NY, 11733, USA (Type of address: Service of Process)
2020-04-09 2025-05-12 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
250521002943 2025-05-12 CERTIFICATE OF DISSOLUTION-CANCELLATION 2025-05-12
200904000042 2020-09-04 CERTIFICATE OF CHANGE 2020-09-04
200409000084 2020-04-09 CERTIFICATE OF INCORPORATION 2020-04-09

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Date of last update: 22 Mar 2025

Sources: New York Secretary of State