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BIG LEAP MEDICAL GROUP PA

Company Details

Name: BIG LEAP MEDICAL GROUP PA
Jurisdiction: New York
Legal type: FOREIGN PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 29 Jul 2024 (10 months ago)
Entity Number: 7385331
ZIP code: 10016
County: New York
Place of Formation: New Jersey
Foreign Legal Name: BIG LEAP MEDICAL GROUP PA
Address: 169 MADISON AVE, STE 2828, NEW YORK, NY, United States, 10016

Contact Details

Phone +1 332-334-1511

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 169 MADISON AVE, STE 2828, NEW YORK, NY, United States, 10016

National Provider Identifier

NPI Number:
1821841503
Certification Date:
2024-08-01

Authorized Person:

Name:
SUMEET VADERA
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207L00000X - Anesthesiology Physician
Is Primary:
No
Selected Taxonomy:
207P00000X - Emergency Medicine Physician
Is Primary:
No
Selected Taxonomy:
207T00000X - Neurological Surgery Physician
Is Primary:
Yes
Selected Taxonomy:
2084P0800X - Psychiatry Physician
Is Primary:
No
Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
No

Contacts:

Filings

Filing Number Date Filed Type Effective Date
240730019731 2024-07-29 APPLICATION OF AUTHORITY 2024-07-29

Date of last update: 19 Mar 2025

Sources: New York Secretary of State