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FORGIE NURSE PRACTITIONER IN PSYCHIATRY HEALTH SERVICES, P.C.

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Company Details

Name: FORGIE NURSE PRACTITIONER IN PSYCHIATRY HEALTH SERVICES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 04 May 2021 (4 years ago)
Entity Number: 6004883
ZIP code: 91361
County: Bronx
Place of Formation: New York
Address: 31416 Agoura Rd., Ste 118, Westlake Village, CA, United States, 91361
Principal Address: 669 East 237th Street, Bronx, NY, United States, 10466

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 31416 Agoura Rd., Ste 118, Westlake Village, CA, United States, 91361

Chief Executive Officer

Name Role Address
ROAN FORGIE Chief Executive Officer 669 EAST 237TH STREET, BRONX, NY, United States, 10466

National Provider Identifier

NPI Number:
1548910698
Certification Date:
2022-03-23

Authorized Person:

Name:
MR. ROAN EMANUEL FORGIE
Role:
PRESIDENT
Phone:

Taxonomy:

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

Contacts:

History

Start date End date Type Value
2021-05-04 2023-08-18 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2021-05-04 2023-08-18 Address 669 EAST 237TH STREET, BRONX, NY, 10466, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
230818001985 2023-08-18 BIENNIAL STATEMENT 2023-05-01
210504000377 2021-05-04 CERTIFICATE OF INCORPORATION 2021-05-04

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Date of last update: 22 Mar 2025

Sources: New York Secretary of State