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ENVISION INTEGRATIVE SERVICES, INC.

Company Details

Name: ENVISION INTEGRATIVE SERVICES, INC.
Jurisdiction: New York
Legal type: DOMESTIC BUSINESS CORPORATION
Status: Active
Date of registration: 27 Oct 2023 (2 years ago)
Entity Number: 7168531
ZIP code: 11716
County: Suffolk
Place of Formation: New York
Address: 1461 Lakeland Ave., Suite 9, Bohemia, NY, United States, 11716

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
Envision Integrative Services, Inc. DOS Process Agent 1461 Lakeland Ave., Suite 9, Bohemia, NY, United States, 11716

National Provider Identifier

NPI Number:
1457113573
Certification Date:
2024-03-28

Authorized Person:

Name:
NICOLE FLEMMING
Role:
BILLING AND CREDENTIALING MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
No
Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
Yes
Selected Taxonomy:
363LA2200X - Adult Health Nurse Practitioner
Is Primary:
No

Contacts:

Fax:
6315857575

Filings

Filing Number Date Filed Type Effective Date
231027000075 2023-10-27 CERTIFICATE OF INCORPORATION 2023-10-27

Date of last update: 20 Mar 2025

Sources: New York Secretary of State