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JR NURSE PRACTITIONER IN PSYCHIATRY, PLLC

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Company Details

Name: JR NURSE PRACTITIONER IN PSYCHIATRY, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 30 Jan 2025 (5 months ago)
Entity Number: 7521952
ZIP code: 12205
County: Saratoga
Place of Formation: New York
Address: 500 NEW KARNER ROAD, PO BOX 15072, ALBANY, NY, United States, 12205

DOS Process Agent

Name Role Address
THE TOWNE LAW FIRM, P.C. DOS Process Agent 500 NEW KARNER ROAD, PO BOX 15072, ALBANY, NY, United States, 12205

National Provider Identifier

NPI Number:
1558169623
Certification Date:
2025-03-02

Authorized Person:

Name:
KENNETH EDICK
Role:
HEALTHCARE ADMINISTRATOR
Phone:

Taxonomy:

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

Contacts:

Fax:
8666162109

History

Start date End date Type Value
2025-01-30 2025-03-26 Address 500 NEW KARNER ROAD, PO BOX 15072, ALBANY, NY, 12205, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
250326000557 2025-03-26 CERTIFICATE OF PUBLICATION 2025-03-26
250130017134 2025-01-30 ARTICLES OF ORGANIZATION 2025-01-30

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Date of last update: 19 Mar 2025

Sources: New York Secretary of State