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5TH AVENUE WELLNESS MEDICINE, P.C.

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Company Details

Name: 5TH AVENUE WELLNESS MEDICINE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 10 Aug 2021 (4 years ago)
Entity Number: 6240842
ZIP code: 11375
County: New York
Place of Formation: New York
Address: 108-37 71st avenue, FOREST HILLS, NY, United States, 11375
Principal Address: 108-37 71st Avenue, Forest Hills, NY, United States, 11375

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
MICHAEL NAYSHTUT Chief Executive Officer 108-37 71ST AVENUE, FOREST HILLS, NY, United States, 11375

Agent

Name Role Address
michael Nayshtut Agent 108-37 71st avenue, FOREST HILLS, NY, 11375

DOS Process Agent

Name Role Address
the corporation DOS Process Agent 108-37 71st avenue, FOREST HILLS, NY, United States, 11375

National Provider Identifier

NPI Number:
1053063644
Certification Date:
2022-01-26

Authorized Person:

Name:
DR. MICHAEL NAYSHTUT
Role:
DO/OWNER
Phone:

Taxonomy:

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

Contacts:

History

Start date End date Type Value
2025-06-28 2025-07-07 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2025-06-10 2025-06-28 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2025-05-30 2025-06-10 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2025-04-18 2025-05-30 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2025-04-09 2025-04-18 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
241105002042 2024-11-05 BIENNIAL STATEMENT 2024-11-05
241106003226 2024-11-05 CERTIFICATE OF CHANGE BY ENTITY 2024-11-05
231018002784 2023-06-15 CERTIFICATE OF CHANGE BY ENTITY 2023-06-15
210811000848 2021-08-10 CERTIFICATE OF INCORPORATION 2021-08-10

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Date of last update: 21 Mar 2025

Sources: New York Secretary of State