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SAMUEL BROWN DO, P.C.

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Company Details

Name: SAMUEL BROWN DO, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 19 May 2020 (5 years ago)
Entity Number: 5753195
ZIP code: 11777
County: Suffolk
Place of Formation: New York
Address: 3 FRANCES LANE, PORT JEFFERSON, NY, United States, 11777

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 3 FRANCES LANE, PORT JEFFERSON, NY, United States, 11777

National Provider Identifier

NPI Number:
1740861855
Certification Date:
2021-04-20

Authorized Person:

Name:
PAUL WINKLER
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
2081P2900X - Pain Medicine (Physical Medicine & Rehabilitation) Physician
Is Primary:
Yes

Contacts:

Fax:
6316291077

Filings

Filing Number Date Filed Type Effective Date
200519000322 2020-05-19 CERTIFICATE OF INCORPORATION 2020-05-19

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Date of last update: 22 Mar 2025

Sources: New York Secretary of State