| | Physician Last Name: | Mineola Medical Practice |
| | Physician First Name: | P.C. |
| | Physician Middle Name: | |
| | Address: | 328 Neptune Avenue
Brooklyn, NY 11235 |
| | License Number: | 207676 |
| | License Type: | |
| | Year of Birth: |
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| | Effective Date: | 01/07/2010 |
| | Action Description for DOH Webpage: | Mineola Medical Practice, P.C. is declared Void ab Inito as a professional corporation and the certificate of incorporation is annulled. |
| | Misconduct Description for DOH Webpage: | The Hearing Committee sustained the charge finding the corporation guilty of willfully failing to comply with Section 1503 of the Business Corporation Law in violation of New York State Education Law Section 6530(16). |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
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