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CHRISTIAN WITHERELL NP IN PSYCHIATRY PLLC

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Company Details

Name: CHRISTIAN WITHERELL NP IN PSYCHIATRY PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 29 Dec 2023 (a year ago)
Entity Number: 7217139
ZIP code: 11971
County: Suffolk
Place of Formation: New York
Address: 19995 soundview avenue, SOUTHOLD, NY, United States, 11971

DOS Process Agent

Name Role Address
the pllc DOS Process Agent 19995 soundview avenue, SOUTHOLD, NY, United States, 11971

National Provider Identifier

NPI Number:
1376314690
Certification Date:
2024-01-15

Authorized Person:

Name:
CHRISTIAN WITHERELL
Role:
SOLE MEMBER
Phone:

Taxonomy:

Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
240102002331 2023-12-29 ARTICLES OF ORGANIZATION 2023-12-29

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Date of last update: 20 Mar 2025

Sources: New York Secretary of State