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LONG WELLNESS MEDICAL PLLC

Company Details

Name: LONG WELLNESS MEDICAL PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 26 Dec 2023 (a year ago)
Entity Number: 7213340
ZIP code: 11021
County: Nassau
Place of Formation: New York
Address: 48a arleigh rd, GREAT NECK, NY, United States, 11021

Contact Details

Phone +1 516-441-5880

Phone +1 718-439-8431

DOS Process Agent

Name Role Address
the llc DOS Process Agent 48a arleigh rd, GREAT NECK, NY, United States, 11021

National Provider Identifier

NPI Number:
1093553729
Certification Date:
2024-07-22

Authorized Person:

Name:
DR. ANN LONG
Role:
PHYSICIAN IN CHARGE
Phone:

Taxonomy:

Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363A00000X - Physician Assistant
Is Primary:
No
Selected Taxonomy:
133VN1006X - Metabolic Nutrition Registered Dietitian
Is Primary:
No
Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
No

Contacts:

Fax:
5164415882

Filings

Filing Number Date Filed Type Effective Date
231226002804 2023-12-26 ARTICLES OF ORGANIZATION 2023-12-26

Date of last update: 20 Mar 2025

Sources: New York Secretary of State