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ISLAND MOBILITY PHYSICAL THERAPY P.C.

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Company Details

Name: ISLAND MOBILITY PHYSICAL THERAPY P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 12 Oct 2022 (3 years ago)
Entity Number: 6613950
ZIP code: 11779
County: Suffolk
Place of Formation: New York
Address: 656 PECONIC STREET, RONKONKOMA, NY, United States, 11779

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE P.C. DOS Process Agent 656 PECONIC STREET, RONKONKOMA, NY, United States, 11779

National Provider Identifier

NPI Number:
1194432773
Certification Date:
2022-11-02

Authorized Person:

Name:
JITHENDRA KUMAR ATTILURU
Role:
PHYSICAL THERAPIST
Phone:

Taxonomy:

Selected Taxonomy:
273Y00000X - Rehabilitation Hospital Unit
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
221012002515 2022-10-12 CERTIFICATE OF INCORPORATION 2022-10-12

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Date of last update: 21 Mar 2025

Sources: New York Secretary of State