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PAUL DEJAC, PHYSICIAN P.C.

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Company Details

Name: PAUL DEJAC, PHYSICIAN P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 05 Dec 2022 (3 years ago)
Entity Number: 6661881
ZIP code: 14214
County: Erie
Place of Formation: New York
Address: 108 starin avenue, BUFFALO, NY, United States, 14214

Contact Details

Phone +1 716-883-0515

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
the corporation DOS Process Agent 108 starin avenue, BUFFALO, NY, United States, 14214

National Provider Identifier

NPI Number:
1548971831
Certification Date:
2023-09-13

Authorized Person:

Name:
LISA ACHTZIGER
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
Yes

Contacts:

Fax:
7168838764

History

Start date End date Type Value
2022-12-05 2025-04-03 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
221206003257 2022-12-05 CERTIFICATE OF INCORPORATION 2022-12-05

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Date of last update: 21 Mar 2025

Sources: New York Secretary of State