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FOREFRONT DERMATOLOGY - EAST PROFESSIONAL, LLC

Company Details

Name: FOREFRONT DERMATOLOGY - EAST PROFESSIONAL, LLC
Jurisdiction: New York
Legal type: FOREIGN PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 30 Aug 2022 (3 years ago)
Entity Number: 6574392
ZIP code: 10005
County: New York
Place of Formation: New Jersey
Foreign Legal Name: FOREFRONT DERMATOLOGY - EAST PROFESSIONAL, LLC
Address: 28 LIBERTY STREET, NEW YORK, NY, United States, 10005

DOS Process Agent

Name Role Address
C T CORPORATION SYSTEM DOS Process Agent 28 LIBERTY STREET, NEW YORK, NY, United States, 10005

National Provider Identifier

NPI Number:
1982390217
Certification Date:
2024-05-30

Authorized Person:

Name:
BETSY J WERNLI
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207ND0101X - MOHS-Micrographic Surgery Physician
Is Primary:
No
Selected Taxonomy:
207NS0135X - Procedural Dermatology Physician
Is Primary:
No
Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
Yes

Contacts:

Fax:
9206841439
Fax:
7189757547

Filings

Filing Number Date Filed Type Effective Date
220830000238 2022-08-30 APPLICATION OF AUTHORITY 2022-08-30

Date of last update: 21 Mar 2025

Sources: New York Secretary of State