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WELLNESS FAMILY HEALTH NP, P.C.

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Company Details

Name: WELLNESS FAMILY HEALTH NP, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 22 Dec 2022 (3 years ago)
Entity Number: 6675368
ZIP code: 10314
County: Richmond
Place of Formation: New York
Address: 1424 Richmond Ave, STE C, STATEN ISLAND, NY, United States, 10314
Principal Address: 1424 Richmond Ave, STE C, Staten Island, NY, United States, 10314

Contact Details

Phone +1 646-763-4574

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
TSZHODERRICK LUM DOS Process Agent 1424 Richmond Ave, STE C, STATEN ISLAND, NY, United States, 10314

Chief Executive Officer

Name Role Address
TSZHODERRICK LUM Chief Executive Officer 1424 RICHMOND AVE, STE C, STATEN ISLAND, NY, United States, 10314

National Provider Identifier

NPI Number:
1841903192
Certification Date:
2023-04-11

Authorized Person:

Name:
DR. TSZHODERRICK LUM
Role:
FAMILY NURSE PRACTITIONER
Phone:

Taxonomy:

Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
7187018103

History

Start date End date Type Value
2022-12-24 2025-03-04 Address 15 perkiomen ave , fl 1, STATEN ISLAND, NY, 10312, USA (Type of address: Service of Process)
2022-12-22 2025-03-04 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
250304005017 2025-03-04 BIENNIAL STATEMENT 2025-03-04
221224000069 2022-12-22 CERTIFICATE OF INCORPORATION 2022-12-22

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Date of last update: 20 Mar 2025

Sources: New York Secretary of State