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PEDIATRIC NURSE PRACTITIONER, PLLC

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Company Details

Name: PEDIATRIC NURSE PRACTITIONER, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 27 May 2021 (4 years ago)
Entity Number: 6023921
ZIP code: 11566
County: Kings
Place of Formation: New York
Address: 2944 HOLIDAY PARK DRIVE, MERRICK, NY, United States, 11566

Contact Details

Phone +1 646-784-6449

Phone +1 646-802-9373

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 2944 HOLIDAY PARK DRIVE, MERRICK, NY, United States, 11566

National Provider Identifier

NPI Number:
1144993080
Certification Date:
2021-07-27

Authorized Person:

Name:
JOY BEVERLY STENNETT
Role:
CPNP
Phone:

Taxonomy:

Selected Taxonomy:
363LP0200X - Pediatric Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
5168099855

Filings

Filing Number Date Filed Type Effective Date
210527000624 2021-05-27 ARTICLES OF ORGANIZATION 2021-05-27

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Date of last update: 22 Mar 2025

Sources: New York Secretary of State