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EASTBAY MEDICAL P.C.

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Company Details

Name: EASTBAY MEDICAL P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 16 Jan 2024 (a year ago)
Entity Number: 7230457
ZIP code: 11710
County: Nassau
Place of Formation: New York
Address: 2307 bellmore ave, BELLMORE, NY, United States, 11710

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
the corporation DOS Process Agent 2307 bellmore ave, BELLMORE, NY, United States, 11710

National Provider Identifier

NPI Number:
1063272474
Certification Date:
2024-03-21

Authorized Person:

Name:
JORDAN FABRIKANT
Role:
DO
Phone:

Taxonomy:

Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
Yes

Contacts:

Fax:
5163087071

Filings

Filing Number Date Filed Type Effective Date
240117001032 2024-01-16 CERTIFICATE OF INCORPORATION 2024-01-16

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Date of last update: 19 Mar 2025

Sources: New York Secretary of State