| | Physician Last Name: | Tribeca Medical |
| | Physician First Name: | P.C. |
| | Physician Middle Name: | |
| | Address: | 280 Riverside Drive, Suite 5K
New York, NY 10025 |
| | License Number: | 204777 |
| | License Type: | |
| | Year of Birth: |
|
| | Effective Date: | 03/16/2009 |
| | Action Description for DOH Webpage: | Annulment of Certificate of Incorporation |
| | Misconduct Description for DOH Webpage: | The Review Board affirmed the October 13, 2008 Hearing Committee decision finding the corporation guilty of the charge of failing to comply with New York State Business Corporation Law Sections 1503 and 1514. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
|
