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REGINA FONG NP IN PSYCHIATRY, P.C.

Company Details

Name: REGINA FONG NP IN PSYCHIATRY, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 22 Mar 2021 (4 years ago)
Entity Number: 5969353
ZIP code: 11780
County: Suffolk
Place of Formation: New York
Address: 480 NORTH COUNTRY ROAD, SAINT JAMES, NY, United States, 11780

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 480 NORTH COUNTRY ROAD, SAINT JAMES, NY, United States, 11780

National Provider Identifier

NPI Number:
1265195697
Certification Date:
2021-10-21

Authorized Person:

Name:
REGINA FONG
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
210322000797 2021-03-22 CERTIFICATE OF INCORPORATION 2021-03-22

Date of last update: 22 Mar 2025

Sources: New York Secretary of State