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KNOX PAIN MANAGEMENT MEDICAL PRACTICE, PLLC

Company Details

Name: KNOX PAIN MANAGEMENT MEDICAL PRACTICE, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 09 Jun 2021 (4 years ago)
Entity Number: 6032462
ZIP code: 06877
County: Westchester
Place of Formation: New York
Address: 54 WOODCHUCK LANE, RIDGEFIELD, CT, United States, 06877

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 54 WOODCHUCK LANE, RIDGEFIELD, CT, United States, 06877

National Provider Identifier

NPI Number:
1104593870
Certification Date:
2021-09-09

Authorized Person:

Name:
JENNY NEWCOMB
Role:
OFFICE
Phone:

Taxonomy:

Selected Taxonomy:
207LP2900X - Pain Medicine (Anesthesiology) Physician
Is Primary:
Yes

Contacts:

Fax:
6317361332

Form 5500 Series

Employer Identification Number (EIN):
871242116
Plan Year:
2023
Number Of Participants:
3
Sponsors Telephone Number:

Filings

Filing Number Date Filed Type Effective Date
210609000535 2021-06-09 ARTICLES OF ORGANIZATION 2021-06-09

Date of last update: 22 Mar 2025

Sources: New York Secretary of State