| Name: | DR. BERT FORMAN PHYSICIAN, P.C. |
| Jurisdiction: | New York |
| Legal type: | DOMESTIC PROFESSIONAL SERVICE CORPORATION |
| Status: | Active |
| Date of registration: | 28 Dec 1990 (34 years ago) |
| Entity Number: | 1497994 |
| County: | Nassau |
| Place of Formation: | New York |
| Address: | 2708 MORTON AVENUE, OCEANSIDE, NY, United States, 11572 |
| Address ZIP Code: | 11572 |
| Principal Address: | 713 BROOKLYN AVENUE, BALDWIN, NY, United States, 11510 |
| Principal Address ZIP Code: | 11510 |
Shares Details
Shares issued 200
Share Par Value 0
Type NO PAR VALUE
| Name | Role | Address |
|---|---|---|
| BERT FORMAN | Chief Executive Officer | 713 BROOKLYN AVENUE, BALDWIN, NY, United States, 11510 |
| Name | Role | Address |
|---|---|---|
| THE CORPORATION | DOS Process Agent | 2708 MORTON AVENUE, OCEANSIDE, NY, United States, 11572 |
| Filing Number | Date Filed | Type | Effective Date |
|---|---|---|---|
| 931229002195 | 1993-12-29 | BIENNIAL STATEMENT | 1993-12-01 |
| 901228000027 | 1990-12-28 | CERTIFICATE OF INCORPORATION | 1990-12-28 |
Date of last update: 14 Nov 2024
Sources: New York Secretary of State
