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SUITE 69 MEDICAL P.C.

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Company Details

Name: SUITE 69 MEDICAL P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 08 Nov 2024 (9 months ago)
Entity Number: 7461980
ZIP code: 11215
County: Kings
Place of Formation: New York
Address: 275 9TH ST, SUITE 69, BROOKLYN, NY, United States, 11215

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE P.C. DOS Process Agent 275 9TH ST, SUITE 69, BROOKLYN, NY, United States, 11215

National Provider Identifier

NPI Number:
1104634773
Certification Date:
2025-04-14

Authorized Person:

Name:
TERRY-JAN BLACKETT-BONNETT
Role:
AUTHORIZED OFFICIAL
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
241112001259 2024-11-08 CERTIFICATE OF INCORPORATION 2024-11-08

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Date of last update: 19 Mar 2025

Sources: New York Secretary of State