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STATION CARE NP IN ADULT HEALTH P.C.

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Company Details

Name: STATION CARE NP IN ADULT HEALTH P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 26 Dec 2024 (7 months ago)
Entity Number: 7494033
ZIP code: 11746
County: Suffolk
Place of Formation: New York
Address: 1757 NEW YORK AVE, HUNTINGTON STATION, NY, United States, 11746

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 1757 NEW YORK AVE, HUNTINGTON STATION, NY, United States, 11746

National Provider Identifier

NPI Number:
1801605761
Certification Date:
2025-01-06

Authorized Person:

Name:
MUBUSHAR IKRAM RAZA
Role:
OWNER/PROVIDER
Phone:

Taxonomy:

Selected Taxonomy:
363LA2200X - Adult Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
6319618775

Filings

Filing Number Date Filed Type Effective Date
241227001479 2024-12-26 CERTIFICATE OF INCORPORATION 2024-12-26

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Date of last update: 19 Mar 2025

Sources: New York Secretary of State