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EDWARD BALZER, NURSE PRACTITIONER IN PSYCHIATRY, P.C.

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Company Details

Name: EDWARD BALZER, NURSE PRACTITIONER IN PSYCHIATRY, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 17 Jan 2025 (6 months ago)
Entity Number: 7513293
ZIP code: 11951
County: Suffolk
Place of Formation: New York
Address: 51 riviera drive, MASTIC BEACH, NY, United States, 11951

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
the corporation DOS Process Agent 51 riviera drive, MASTIC BEACH, NY, United States, 11951

National Provider Identifier

NPI Number:
1821891458
Certification Date:
2025-03-29

Authorized Person:

Name:
MR. EDWARD F BALZER
Role:
OWNER/CEO
Phone:

Taxonomy:

Selected Taxonomy:
363LP0808X - Psychiatric/Mental Health Nurse Practitioner
Is Primary:
Yes

Contacts:

Filings

Filing Number Date Filed Type Effective Date
250121001355 2025-01-17 CERTIFICATE OF INCORPORATION 2025-01-17

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Date of last update: 19 Mar 2025

Sources: New York Secretary of State