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WALTER BENNETT, NP IN FAMILY HEALTH PLLC

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Company Details

Name: WALTER BENNETT, NP IN FAMILY HEALTH PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 02 Jan 2025 (7 months ago)
Entity Number: 7498216
ZIP code: 11801
County: Nassau
Place of Formation: New York
Address: 125 jerusalem ave,, suite a, HICKSVILLE, NY, United States, 11801

DOS Process Agent

Name Role Address
walter bennett DOS Process Agent 125 jerusalem ave,, suite a, HICKSVILLE, NY, United States, 11801

National Provider Identifier

NPI Number:
1942022694
Certification Date:
2024-11-04

Authorized Person:

Name:
WALTER BENNETT
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
250103001069 2025-01-02 ARTICLES OF ORGANIZATION 2025-01-02

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Date of last update: 19 Mar 2025

Sources: New York Secretary of State