| Name: | WANTAGH OB/GYN P.C. |
| Jurisdiction: | New York |
| Legal type: | DOMESTIC PROFESSIONAL SERVICE CORPORATION |
| Status: | Active |
| Date of registration: | 06 Nov 1995 (29 years ago) |
| Entity Number: | 1970885 |
| ZIP code: | 11793 |
| County: | Nassau |
| Place of Formation: | New York |
| Address: | 2155 WANTAGH AVE, WANTAGH, NY, United States, 11793 |
Shares Details
Shares issued 200
Share Par Value 0
Type NO PAR VALUE
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SUDHA KUNCHAM, MD RETIREMENT PLAN | 2012 | 113293241 | 2013-06-27 | WANTAGH OB/GYN, P.C. | 1 | |||||||||||||||||||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2013-06-27 |
| Name of individual signing | SUDHA KUNCHAM |
| Role | Employer/plan sponsor |
| Date | 2013-06-27 |
| Name of individual signing | SUDHA KUNCHAM |
| File | View Page |
| Three-digit plan number (PN) | 003 |
| Effective date of plan | 2005-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 5163792689 |
| Plan sponsor’s address | 10 DEBRA COURT, OLD WESTBURY, NY, 11568 |
Plan administrator’s name and address
| Administrator’s EIN | 113293241 |
| Plan administrator’s name | WANTAGH OB/GYN, P.C. |
| Plan administrator’s address | 10 DEBRA COURT, OLD WESTBURY, NY, 11568 |
| Administrator’s telephone number | 5163792689 |
Signature of
| Role | Plan administrator |
| Date | 2012-07-26 |
| Name of individual signing | SUDHA KUNCHAM |
| Role | Employer/plan sponsor |
| Date | 2012-07-26 |
| Name of individual signing | SUDHA KUNCHAM |
| File | View Page |
| Three-digit plan number (PN) | 003 |
| Effective date of plan | 2005-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 5163792689 |
| Plan sponsor’s address | 10 DEBRA COURT, OLD WESTBURY, NY, 11568 |
Plan administrator’s name and address
| Administrator’s EIN | 113293241 |
| Plan administrator’s name | WANTAGH OB/GYN, P.C. |
| Plan administrator’s address | 10 DEBRA COURT, OLD WESTBURY, NY, 11568 |
| Administrator’s telephone number | 5163792689 |
Signature of
| Role | Plan administrator |
| Date | 2011-07-18 |
| Name of individual signing | SUDHA KUNCHAM |
| Role | Employer/plan sponsor |
| Date | 2011-07-18 |
| Name of individual signing | SUDHA KUNCHAM |
| File | View Page |
| Three-digit plan number (PN) | 003 |
| Effective date of plan | 2005-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 5162216500 |
| Plan sponsor’s address | 10 DEBRA COURT, OLD WESTBURY, NY, 11568 |
Plan administrator’s name and address
| Administrator’s EIN | 113293241 |
| Plan administrator’s name | WANTAGH OB/GYN, P.C. |
| Plan administrator’s address | 10 DEBRA COURT, OLD WESTBURY, NY, 11568 |
| Administrator’s telephone number | 5162216500 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-06 |
| Name of individual signing | SUDHA KUNCHAM |
| Role | Employer/plan sponsor |
| Date | 2010-10-06 |
| Name of individual signing | SUDHA KUNCHAM |
| Name | Role | Address |
|---|---|---|
| THE CORPORATION | DOS Process Agent | 2155 WANTAGH AVE, WANTAGH, NY, United States, 11793 |
| Name | Role | Address |
|---|---|---|
| SUDHA KUNCHAM MD | Chief Executive Officer | 2155 WANTAGH AVE, WANTAGH, NY, United States, 11793 |
| Start date | End date | Type | Value |
|---|---|---|---|
| 2005-10-17 | 2005-12-08 | Address | 2155 WANTAGH AVE, WANTAGH, NY, 11793, 3915, USA (Type of address: Principal Executive Office) |
| 2005-10-17 | 2005-12-08 | Address | 2155 WANTAGH AVE, WANTAGH, NY, 11793, 3915, USA (Type of address: Chief Executive Officer) |
| 2005-10-14 | 2005-10-17 | Address | 2155 WANTAGH AVENUE, WANTAGH, NY, 11793, USA (Type of address: Service of Process) |
| 2003-10-29 | 2005-10-17 | Address | 1228 WANTAGH AVE / SUITE 104, WANTAGH, NY, 11793, USA (Type of address: Principal Executive Office) |
| 2003-10-29 | 2005-10-17 | Address | 1228 WANTAGH AVE / SUITE 104, WANTAGH, NY, 11793, USA (Type of address: Chief Executive Officer) |
| 2003-10-29 | 2005-10-14 | Address | 1228 WANTAGH AVE / SUITE 104, WANTAGH, NY, 11793, USA (Type of address: Service of Process) |
| 1999-12-08 | 2003-10-29 | Address | 1228 WANTAGH AVE, WANTAGH, NY, 11793, USA (Type of address: Principal Executive Office) |
| 1999-12-08 | 2003-10-29 | Address | 1228 WANTAGH AVE, WANTAGH, NY, 11793, USA (Type of address: Chief Executive Officer) |
| 1995-11-06 | 2003-10-29 | Address | 1228 WANGTAGH AVENUE, WANTAGH, NY, 11793, USA (Type of address: Service of Process) |
| Filing Number | Date Filed | Type | Effective Date |
|---|---|---|---|
| 051208003108 | 2005-12-08 | AMENDMENT TO BIENNIAL STATEMENT | 2005-11-01 |
| 051017002584 | 2005-10-17 | BIENNIAL STATEMENT | 2005-11-01 |
| 051014000035 | 2005-10-14 | CERTIFICATE OF CHANGE | 2005-10-14 |
| 031029002643 | 2003-10-29 | BIENNIAL STATEMENT | 2003-11-01 |
| 011105002153 | 2001-11-05 | BIENNIAL STATEMENT | 2001-11-01 |
| 991208002378 | 1999-12-08 | BIENNIAL STATEMENT | 1999-11-01 |
| 951106000046 | 1995-11-06 | CERTIFICATE OF INCORPORATION | 1995-11-06 |
Date of last update: 13 Nov 2024
Sources: New York Secretary of State
