| Name: | QUEENS-LONG ISLAND MEDICAL GROUP, P.C. |
| Jurisdiction: | New York |
| Legal type: | DOMESTIC PROFESSIONAL SERVICE CORPORATION |
| Status: | Inactive |
| Date of registration: | 21 Nov 1990 (34 years ago) |
| Date of dissolution: | 31 Dec 2016 |
| Entity Number: | 1490391 |
| ZIP code: | 10041 |
| County: | New York |
| Place of Formation: | New York |
| Address: | 55 WATER STREET, NEW YORK, NY, United States, 10041 |
| Principal Address: | ADVANTAGECARE PHYSICIANS, P.C., 55 WATER STREET, NEW YORK, NY, United States, 10041 |
Shares Details
Shares issued 1500
Share Par Value 0
Type NO PAR VALUE
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| QUEENS LONG ISLAND MEDICAL GROUP P.C.N.Q. LOCAL 153 SAVINGS AND INVESTMENT PLAN | 2010 | 113039101 | 2011-10-31 | QUEENS-LONG ISLAND MEDICAL GROUP, P.C. | 109 | |||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 113039101 |
| Plan administrator’s name | QUEENS-LONG ISLAND MEDICAL GROUP, P.C. |
| Plan administrator’s address | 1000 ZECKENDORF BLVD, GARDEN CITY, NY, 115300000 |
| Administrator’s telephone number | 5165426861 |
Signature of
| Role | Plan administrator |
| Date | 2011-10-31 |
| Name of individual signing | NIKI KALAITZIS |
| Name | Role | Address |
|---|---|---|
| QUEENS-LONG ISLAND MEDICAL GROUP, P.C. | DOS Process Agent | 55 WATER STREET, NEW YORK, NY, United States, 10041 |
| Name | Role | Address |
|---|---|---|
| NAVARRA RODRIGUEZ, M.D. | Chief Executive Officer | 55 WATER STREET, NEW YORK, NY, United States, 10041 |
| Start date | End date | Type | Value |
|---|---|---|---|
| 2015-01-08 | 2016-10-05 | Address | 55 WATER STREET, NEW YORK, NY, 10041, USA (Type of address: Chief Executive Officer) |
| 2015-01-08 | 2016-10-05 | Address | 55 WATER STREET, NEW YORK, NY, 10041, USA (Type of address: Principal Executive Office) |
| 2013-03-29 | 2015-01-08 | Address | C/O EMBLEMHEALTH, 441 NINTH AVENUE, NEW YORK, NY, 10001, USA (Type of address: Service of Process) |
| 2013-01-17 | 2015-01-08 | Address | 1000 ZECKENDORF BLVD, GARDEN CITY, NY, 11530, USA (Type of address: Principal Executive Office) |
| 2013-01-17 | 2015-01-08 | Address | 1000 ZECKENDORF BLVD, GARDEN CITY, NY, 11530, USA (Type of address: Chief Executive Officer) |
| 2013-01-17 | 2013-03-29 | Address | 800 AXINN AVE, GARDEN CITY, NY, 11530, USA (Type of address: Service of Process) |
| 2002-05-29 | 2013-01-17 | Address | 106 EAB PLAZA, WEST TOWER, 12TH FLOOR, UNIONDALE, NY, 11556, 0106, USA (Type of address: Service of Process) |
| 2002-05-29 | 2013-02-21 | Shares | Share type: NO PAR VALUE, Number of shares: 1500, Par value: 0 |
| 1996-11-27 | 2013-01-17 | Address | 106 EAB PLAZA, UNIONDALE, NY, 11556, USA (Type of address: Chief Executive Officer) |
| 1996-11-27 | 2002-05-29 | Address | 106 EAB PLAZA, UNIONDALE, NY, 11556, 0106, USA (Type of address: Service of Process) |
| Filing Number | Date Filed | Type | Effective Date |
|---|---|---|---|
| 161216000136 | 2016-12-16 | CERTIFICATE OF MERGER | 2016-12-31 |
| 161123006130 | 2016-11-23 | BIENNIAL STATEMENT | 2016-11-01 |
| 161005002045 | 2016-10-05 | AMENDMENT TO BIENNIAL STATEMENT | 2014-11-01 |
| 150108006180 | 2015-01-08 | BIENNIAL STATEMENT | 2014-11-01 |
| 130329000290 | 2013-03-29 | CERTIFICATE OF AMENDMENT | 2013-03-29 |
| 130221000510 | 2013-02-21 | CERTIFICATE OF AMENDMENT | 2013-02-21 |
| 130117002200 | 2013-01-17 | BIENNIAL STATEMENT | 2012-11-01 |
| 020529000454 | 2002-05-29 | CERTIFICATE OF AMENDMENT | 2002-05-29 |
| 001109002021 | 2000-11-09 | BIENNIAL STATEMENT | 2000-11-01 |
| 990119002635 | 1999-01-19 | BIENNIAL STATEMENT | 1998-11-01 |
Date of last update: 14 Nov 2024
Sources: New York Secretary of State
