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LISA BLUM PHYSICAL THERAPY PLLC

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Company Details

Name: LISA BLUM PHYSICAL THERAPY PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 21 Apr 2021 (4 years ago)
Entity Number: 5995057
ZIP code: 11758
County: New York
Place of Formation: New York
Address: 96 FRANKEL ROAD, MASSAPEQUA, NY, United States, 11758

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 96 FRANKEL ROAD, MASSAPEQUA, NY, United States, 11758

National Provider Identifier

NPI Number:
1346823069
Certification Date:
2021-04-30

Authorized Person:

Name:
LISA BLUM
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
863591482
Plan Year:
2023
Number Of Participants:
1
Sponsors Telephone Number:

Filings

Filing Number Date Filed Type Effective Date
210421000568 2021-04-21 ARTICLES OF ORGANIZATION 2021-04-21

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Date of last update: 22 Mar 2025

Sources: New York Secretary of State