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PAIN MEDICINE P.C.

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Company Details

Name: PAIN MEDICINE P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 28 May 2024 (a year ago)
Entity Number: 7350555
ZIP code: 11963
County: Suffolk
Place of Formation: New York
Address: 40 LINCOLN ST, SAG HARBOR, NY, United States, 11963

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
the corporation DOS Process Agent 40 LINCOLN ST, SAG HARBOR, NY, United States, 11963

National Provider Identifier

NPI Number:
1184467482
Certification Date:
2024-06-14

Authorized Person:

Name:
RANDA JAAFAR
Role:
MD
Phone:

Taxonomy:

Selected Taxonomy:
208VP0000X - Pain Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
5167942994

Filings

Filing Number Date Filed Type Effective Date
240612002586 2024-05-28 CERTIFICATE OF INCORPORATION 2024-06-12

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Date of last update: 19 Mar 2025

Sources: New York Secretary of State