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MALLARD PROFESSIONAL SERVICES, INC.

Company Details

Name: MALLARD PROFESSIONAL SERVICES, INC.
Jurisdiction: New York
Legal type: DOMESTIC BUSINESS CORPORATION
Status: Active
Date of registration: 11 Jul 2023 (2 years ago)
Entity Number: 6933028
ZIP code: 11758
County: Nassau
Place of Formation: New York
Address: 5550 MERRICK ROAD, SUITE 300, MASSAPEQUA, NY, United States, 11758

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
JAMES J. QUAIL DOS Process Agent 5550 MERRICK ROAD, SUITE 300, MASSAPEQUA, NY, United States, 11758

National Provider Identifier

NPI Number:
1699455519
Certification Date:
2023-08-02

Authorized Person:

Name:
DONNA SCOCA
Role:
CREDENTIALING
Phone:

Taxonomy:

Selected Taxonomy:
207P00000X - Emergency Medicine Physician
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No

Contacts:

Fax:
6316731314

Filings

Filing Number Date Filed Type Effective Date
230711003131 2023-07-11 CERTIFICATE OF INCORPORATION 2023-07-11

Date of last update: 20 Mar 2025

Sources: New York Secretary of State