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BRIAN GHEZELAIAGH, M.D., P.C.

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Company Details

Name: BRIAN GHEZELAIAGH, M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 24 Feb 2023 (2 years ago)
Entity Number: 6742228
ZIP code: 11790
County: Suffolk
Place of Formation: New York
Address: 2500 nesconset highway, building 17 c, STONY BROOK, NY, United States, 11790

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
the professional corporation DOS Process Agent 2500 nesconset highway, building 17 c, STONY BROOK, NY, United States, 11790

National Provider Identifier

NPI Number:
1659140747
Certification Date:
2023-12-29

Authorized Person:

Name:
DR. BRIAN GHEZELAIAGH
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
Yes

Contacts:

Fax:
6312927376

Filings

Filing Number Date Filed Type Effective Date
230225001246 2023-02-24 CERTIFICATE OF INCORPORATION 2023-02-24

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Date of last update: 20 Mar 2025

Sources: New York Secretary of State