136 BOWERY #2001, NEW YORK, 10013, NEW YORK
| Entity Name | JASON HALEGOUA, M.D., P.C. |
| Entity Number | 3865654 |
| Status | ACTIVE |
| Incorporation Date | 9th October 2009 |
| Dos Process Address | 2799 ROUTE 112, MEDFORD, 11763, NEW YORK |
| Jurisdiction | NEW YORK |
| County | SUFFOLK |
| Legal form | DOMESTIC PROFESSIONAL CORPORATION |