| Physician Last Name: | J.P. Medical |
| Physician First Name: | P.C. |
| Physician Middle Name: | |
| Address: | 54-03 Queens Boulevard
Woodside, NY 11377 |
| License Number: | 119256 |
| License Type: | |
| Year of Birth: |
|
| Effective Date: | 02/07/2011 |
| Action Description for DOH Webpage: | Annulment of the corporation's certificate of incorporation. |
| Misconduct Description for DOH Webpage: | The corporation admitted to the charge of failing to comply with the requirements of the New York State Business Corporation Law. |
| License Limitations or Conditions for DOH Webpage: | |
| Board Order: |
|