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ILANA ETELZON, MD, P.C.

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Company Details

Name: ILANA ETELZON, MD, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 20 Aug 2020 (5 years ago)
Entity Number: 5817465
ZIP code: 07020
County: Albany
Place of Formation: New York
Address: 814 UNDERCLIFF AVE, EDGEWATER, NJ, United States, 07020

Contact Details

Phone +1 718-682-3686

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 814 UNDERCLIFF AVE, EDGEWATER, NJ, United States, 07020

National Provider Identifier

NPI Number:
1104428796
Certification Date:
2022-05-16

Authorized Person:

Name:
ILANA ETELZON
Role:
MD
Phone:

Taxonomy:

Selected Taxonomy:
261QM2500X - Medical Specialty Clinic/Center
Is Primary:
No
Selected Taxonomy:
2081P2900X - Pain Medicine (Physical Medicine & Rehabilitation) Physician
Is Primary:
Yes

Contacts:

Fax:
7186823658

History

Start date End date Type Value
2025-04-03 2025-05-20 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2025-04-03 2025-05-20 Address 3 Somerset Lane, Unit 500, EDGEWATER, NJ, 07020, USA (Type of address: Service of Process)
2025-04-03 2025-05-20 Address 3 SOMERSET LANE, UINT 500, EDGEWATER, NJ, 07020, USA (Type of address: Chief Executive Officer)
2025-01-13 2025-04-03 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2023-06-27 2025-01-13 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
250520003085 2025-05-20 CERTIFICATE OF DISSOLUTION-CANCELLATION 2025-05-20
250403002023 2025-04-03 BIENNIAL STATEMENT 2025-04-03
200820000410 2020-08-20 CERTIFICATE OF INCORPORATION 2020-08-20

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Date of last update: 22 Mar 2025

Sources: New York Secretary of State