Proof of Service: Nicholas James Ryan v. Elizabeth S. Lustrin M.D., Christopher R. Wilkins M.D., Bhumika Balgobin M.D., Marlon Seliger M.D., Ajay K. Misra M.D., Suchismita Datta M.D., Nyu Langone Radiology Associates, Nyu Langone Ambulatory Care East Meadow, Advanced Neurological Services Of Long Island P.C., Nyu Emergency Medicine, Nyu Langone Hospital-Long Island f/k/a NYU WINTHROP HOSPITAL, Nyu Langone Health System

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                                FILED: NASSAU COUNTY CLERK 09/15/2023 12:24 PM                                                                    INDEX NO. 614075/2023
NYSCEF DOC. NO. 12                                                                                    RECEIVED NYSCEF: 09/15/2023

         Form 27   -   AFFIDAVIT   OF SERVICE
                                                                                                             P9934837

              SIEGEL & COONERTY ESQ    Lina Vargas
        SUPREME COURT NASSAU COUNTY STATE OF NEW YORK
        NICHOLAS JAMES RYAN                                                                            Index No. 614075/2023
                                                                                     PLAINTIFF        Date Filed
                                                      - vs -                                          Office No. 22-1139
        ELIZABETH S. LUSTRIN, M.D., ETAL                                                              Court Date.
                                                                                     DEFENDANT
                   STATE OF NEW YORK, COUNTY OF NEW YORK                      :SS:
        FREDDI SIMON being duly sworn, deposes and says; I am over 18 years of age, not a party
        to this action, and reside in the State of New York. That on the 05TH day of SEPTEMBER,
        2023 1:20PM at
        550 FIRST AVENUE
        NEW YORK NY          10016
        I served       a   true copy of the
                                     SUMMONS AND VERIFIED COMPLAINT, BEARING INDEX NUMBER AND
        DATE FILED, CERTIFICATION PURSUANT TO CPLR 3012A, NOTICE REGARDING AVAILABILITY OF
        ELECTRONIC FILING SUPREME COURT CASES, ATTORNEY'S VERIFICATION upon NYU LANGONE HEALTH
        SYSTEM the DEFENDANT therein named by delivering to, and leaving personally with HELEN
        M. (REFUSED FULL NAME) , RISK MANAGEMENT CLERK, who provided verbal confirmation that he
        or she is authorized to accept by appointment or law to receive service                              on   behalf of the
        DEFENDANT .

        Deponent describes the person served as aforesaid to the best                            of deponent's     ability   at
        the time and circumstances of the service as follows:
         SEX: FEMALE            COLOR: WHITE HAIR: BLONDE
         APP.AGE: 50-65 APP. HT:               5'3    APP. WT: 120
         OTHER     IDENTIFYING FEATURES
         Glasses


         Sworn     to before       me   this
         06TH day       of   SEPTEMBER,

                                                                                 FREDDI SIMON 2066183
                                                                                 Lexitas
         SELENA INES AD            E                                             1235 BROADWAY 2ND FLOOR
         Notary Public, State of                New   York                       NEW YORK, NY 10001
         No. 01AD6365042                                                         Reference No: 3-SC1-9934837
         Qualified in         QUEENS COUNTY
         Commission Expires 09/25/2025




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