Search icon

PAVEL ODINTSOV NP IN ADULT HEALTH PLLC

Company Details

Name: PAVEL ODINTSOV NP IN ADULT HEALTH PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 11 Apr 2023 (2 years ago)
Entity Number: 6795974
ZIP code: 10956
County: Rockland
Place of Formation: New York
Address: 182 s main st, NEW CITY, NY, United States, 10956

DOS Process Agent

Name Role Address
PAVEL ODINTSOV NP IN ADULT HEALTH PLLC DOS Process Agent 182 s main st, NEW CITY, NY, United States, 10956

National Provider Identifier

NPI Number:
1851121610
Certification Date:
2024-08-06

Authorized Person:

Name:
PAVEL ODINTSOV
Role:
OWNER/NURSE PRACTITIONER
Phone:

Taxonomy:

Selected Taxonomy:
251S00000X - Community/Behavioral Health Agency
Is Primary:
No
Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363LP2300X - Primary Care Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363LA2200X - Adult Health Nurse Practitioner
Is Primary:
Yes

Contacts:

History

Start date End date Type Value
2023-04-11 2024-09-10 Address 182 s main st, NEW CITY, NY, 10956, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240910002787 2024-08-29 CERTIFICATE OF PUBLICATION 2024-08-29
230411003161 2023-04-11 ARTICLES OF ORGANIZATION 2023-04-11

Date of last update: 20 Mar 2025

Sources: New York Secretary of State