| Name: | FORM HEALTH ASSOCIATES (MA), P.C. |
| Jurisdiction: | New York |
| Legal type: | FOREIGN PROFESSIONAL SERVICE CORPORATION |
| Status: | Active |
| Date of registration: | 14 Aug 2020 (4 years ago) |
| Entity Number: | 5812738 |
| ZIP code: | 10005 |
| County: | New York |
| Place of Formation: | Massachusetts |
| Address: | 28 LIBERTY STREET, NEW YORK, NY, United States, 10005 |
| Principal Address: | 109 State Street, 5th Floor, Boston, MA, United States, 02109 |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | DOS Process Agent | 28 LIBERTY STREET, NEW YORK, NY, United States, 10005 |
| Name | Role | Address |
|---|---|---|
| NAM KIM, M.D. | Chief Executive Officer | 109 STATE STREET, 5TH FLOOR, BOSTON, MA, United States, 02109 |
| Start date | End date | Type | Value |
|---|---|---|---|
| 2024-08-02 | 2024-08-02 | Address | 109 STATE STREET, 5TH FLOOR, BOSTON, MA, 02109, USA (Type of address: Chief Executive Officer) |
| 2024-08-02 | 2024-08-02 | Address | 179 LINCOLN STREET, SUITE 404, BOSTON, MA, 02111, USA (Type of address: Chief Executive Officer) |
| 2020-08-14 | 2024-08-02 | Address | 28 LIBERTY STREET, NEW YORK, NY, 10005, USA (Type of address: Service of Process) |
| Filing Number | Date Filed | Type | Effective Date |
|---|---|---|---|
| 240802003997 | 2024-08-02 | BIENNIAL STATEMENT | 2024-08-02 |
| 220802001132 | 2022-08-02 | BIENNIAL STATEMENT | 2022-08-01 |
| 200814000302 | 2020-08-14 | APPLICATION OF AUTHORITY | 2020-08-14 |
Date of last update: 12 Jan 2025
Sources: New York Secretary of State
