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NORTH COUNTRY ADULT MEDICINE, PLLC

Company Details

Name: NORTH COUNTRY ADULT MEDICINE, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 27 May 2003 (21 years ago)
Entity Number: 2911673
County: St. Lawrence
Place of Formation: New York
Address: 38 HOSPITAL DRIVE, MASSENA, NY, United States, 13662
Address ZIP Code: 13662

Contact Details

Phone +1 315-764-1121

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
EJHLN6ZLNZN5 2025-02-14 38 HOSPITAL DR, MASSENA, NY, 13662, 1018, USA 38 HOSPITAL DRIVE, MASSENA, NY, 13662, 2201, USA

Business Information
Congressional District 21
State/Country of Incorporation NY, USA
Activation Date 2024-02-19
Initial Registration Date 2005-10-17
Entity Start Date 2003-10-14
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 621111
Product and Service Codes Q526

Points of Contacts
Electronic Business
Title PRIMARY POC
Name NEIL CICHETTI
Address 38 HOSPITAL DRIVE, MASSENA, NY, 13662, 2201, USA
Title ALTERNATE POC
Name JOANNE CICHETTI
Address 38 HOSPITAL DRIVE, MASSENA, NY, 13662, 2201, USA
Government Business
Title PRIMARY POC
Name NEIL CICHETTI
Address 38 HOSPITAL DRIVE, MASSENA, NY, 13662, 2201, USA
Title ALTERNATE POC
Name JOANNE CICHETTI
Address 38 HOSPITAL DRIVE, MASSENA, NY, 13662, 2201, USA
Past Performance
Title PRIMARY POC
Name JOANNE CICHETTI
Address 38 HOSPITAL DRIVE, MASSENA, NY, 13662, USA
Title ALTERNATE POC
Name NEIL CICHETTI
Address 38 HOSPITAL DRIVE, MASSENA, NY, 13662, USA

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
46HJ4 Active Non-Manufacturer 2005-10-18 2024-03-09 2029-02-19 2025-02-14

Contact Information
POC NEIL CICHETTI
Phone +1 315-764-1121
Fax +1 855-279-7911
Address 38 HOSPITAL DR, MASSENA, NY, 13662 1018, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORTH COUNTRY ADULT MEDICINE, PLLC 401(K) PROFIT SHARING 2023 542111742 2024-09-25 NORTH COUNTRY ADULT MEDICINE, PLLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2022-01-01
Business code 621111
Sponsor’s telephone number 3157641121
Plan sponsor’s address 38 HOSPITAL DRIVE, MASSENA, NY, 13662

Signature of
Role Plan administrator
Date 2024-09-26
Name of individual signing NEIL CICHETTI, MD
Valid signature Filed with authorized/valid electronic signature
NORTH COUNTRY ADULT MEDICINE, PLLC 401(K) PROFIT SHARING 2022 542111742 2023-07-24 NORTH COUNTRY ADULT MEDICINE, PLLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2022-01-01
Business code 621111
Sponsor’s telephone number 3157641121
Plan sponsor’s address 38 HOSPITAL DRIVE, MASSENA, NY, 13662

Signature of
Role Plan administrator
Date 2023-07-24
Name of individual signing NEIL CICHETTI, MD

DOS Process Agent

Name Role Address
NORTH COUNTRY ADULT MEDICINE, PLLC DOS Process Agent 38 HOSPITAL DRIVE, MASSENA, NY, United States, 13662

History

Start date End date Type Value
2009-05-15 2024-02-15 Address 38 HOSPITAL DRIVE, MASSENA, NY, 13662, USA (Type of address: Service of Process)
2005-06-16 2009-05-15 Address FETTER & BURSTEIN, P.C., 507 PLUM ST, STE 300, SYRACUSE, NY, 13204, USA (Type of address: Service of Process)
2003-05-27 2005-06-16 Address FETTER & BURSTEIN, P.C., 90 PRESIDENTIAL PLAZA 5TH FLR., SYRACUSE, NY, 13202, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240215000236 2024-02-15 BIENNIAL STATEMENT 2024-02-15
210503060113 2021-05-03 BIENNIAL STATEMENT 2021-05-01
130524006193 2013-05-24 BIENNIAL STATEMENT 2013-05-01
110526002905 2011-05-26 BIENNIAL STATEMENT 2011-05-01
090515002169 2009-05-15 BIENNIAL STATEMENT 2009-05-01
070515002199 2007-05-15 BIENNIAL STATEMENT 2007-05-01
050616002281 2005-06-16 BIENNIAL STATEMENT 2005-05-01
031006000576 2003-10-06 AFFIDAVIT OF PUBLICATION 2003-10-06
031006000573 2003-10-06 AFFIDAVIT OF PUBLICATION 2003-10-06
030527000952 2003-05-27 ARTICLES OF ORGANIZATION 2003-05-27

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
BPA AWARD DTSL5508AP0064D 2008-09-30 2008-09-30 No data
Unique Award Key CONT_AWD_DTSL5508AP0064D_6947_DTSL5508AP0064_6947
Awarding Agency Department of Transportation
Link View Page

Description
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q526: MEDICAL/PSYCH CONSULTATION SVCS

Recipient Details
Recipient NORTH COUNTRY ADULT MEDICINE, PLLC
UEI EJHLN6ZLNZN5
Legacy DUNS 607831562
Recipient Address UNITED STATES, 4 HARROWGATE COMMONS, MASSENA, 136622201
BPA AWARD DTSL5508AP0064C 2008-06-30 2008-06-30 No data
Unique Award Key CONT_AWD_DTSL5508AP0064C_6947_DTSL5508AP0064_6947
Awarding Agency Department of Transportation
Link View Page

Description
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q526: MEDICAL/PSYCH CONSULTATION SVCS

Recipient Details
Recipient NORTH COUNTRY ADULT MEDICINE, PLLC
UEI EJHLN6ZLNZN5
Legacy DUNS 607831562
Recipient Address UNITED STATES, 4 HARROWGATE COMMONS, MASSENA, 136622201
BPA AWARD DTSL5508AP0064B 2008-03-31 2008-03-31 No data
Unique Award Key CONT_AWD_DTSL5508AP0064B_6947_DTSL5508AP0064_6947
Awarding Agency Department of Transportation
Link View Page

Description
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q526: MEDICAL/PSYCH CONSULTATION SVCS

Recipient Details
Recipient NORTH COUNTRY ADULT MEDICINE, PLLC
UEI EJHLN6ZLNZN5
Legacy DUNS 607831562
Recipient Address UNITED STATES, 4 HARROWGATE COMMONS, MASSENA, 136622201
BPA AWARD DTSL5508AP0064A 2007-12-31 2007-12-31 No data
Unique Award Key CONT_AWD_DTSL5508AP0064A_6947_DTSL5508AP0064_6947
Awarding Agency Department of Transportation
Link View Page

Description
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q526: MEDICAL/PSYCH CONSULTATION SVCS

Recipient Details
Recipient NORTH COUNTRY ADULT MEDICINE, PLLC
UEI EJHLN6ZLNZN5
Legacy DUNS 607831562
Recipient Address UNITED STATES, 4 HARROWGATE COMMONS, MASSENA, 136622201
BPA AWARD DTSL5506AP0064I 2007-12-31 2007-12-31 No data
Unique Award Key CONT_AWD_DTSL5506AP0064I_6947_DTSL5506AP0064_6947
Awarding Agency Department of Transportation
Link View Page

Description
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q526: MEDICAL/PSYCH CONSULTATION SVCS

Recipient Details
Recipient NORTH COUNTRY ADULT MEDICINE, PLLC
UEI EJHLN6ZLNZN5
Legacy DUNS 607831562
Recipient Address UNITED STATES, 4 HARROWGATE COMMONS, MASSENA, 136622201
No data IDV DTSL5510AP0064 2009-09-30 No data No data
Unique Award Key CONT_IDV_DTSL5510AP0064_6947
Awarding Agency Department of Transportation
Link View Page

Description
Title PROVIDE MEDICAL SERVICES AS SSERVE AS CORPORATION MEDICAL DOCTOR, AS NEEDED.
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q526: MEDICAL/PSYCH CONSULTATION SVCS

Recipient Details
Recipient NORTH COUNTRY ADULT MEDICINE, PLLC
UEI EJHLN6ZLNZN5
Legacy DUNS 607831562
Recipient Address UNITED STATES, 38 HOSPITAL DR, MASSENA, 136622201
BPA AWARD DTSL5508AP0064H 2009-09-30 2009-09-30 No data
Unique Award Key CONT_AWD_DTSL5508AP0064H_6947_DTSL5508AP0064_6947
Awarding Agency Department of Transportation
Link View Page

Description
Title BPA CALL
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q526: MEDICAL/PSYCH CONSULTATION SVCS

Recipient Details
Recipient NORTH COUNTRY ADULT MEDICINE, PLLC
UEI EJHLN6ZLNZN5
Legacy DUNS 607831562
Recipient Address UNITED STATES, 4 HARROWGATE COMMONS, MASSENA, 136622201
BPA AWARD DTSL5508AP0064G 2009-06-30 2009-06-30 No data
Unique Award Key CONT_AWD_DTSL5508AP0064G_6947_DTSL5508AP0064_6947
Awarding Agency Department of Transportation
Link View Page

Description
Title BPA CALL
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q526: MEDICAL/PSYCH CONSULTATION SVCS

Recipient Details
Recipient NORTH COUNTRY ADULT MEDICINE, PLLC
UEI EJHLN6ZLNZN5
Legacy DUNS 607831562
Recipient Address UNITED STATES, 4 HARROWGATE COMMONS, MASSENA, 136622201
BPA AWARD DTSL5508AP0064E 2008-12-31 2008-12-31 No data
Unique Award Key CONT_AWD_DTSL5508AP0064E_6947_DTSL5508AP0064_6947
Awarding Agency Department of Transportation
Link View Page

Description
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q526: MEDICAL/PSYCH CONSULTATION SVCS

Recipient Details
Recipient NORTH COUNTRY ADULT MEDICINE, PLLC
UEI EJHLN6ZLNZN5
Legacy DUNS 607831562
Recipient Address UNITED STATES, 4 HARROWGATE COMMONS, MASSENA, 136622201
BPA AWARD DTSL5510AP0064D 2010-09-30 2010-09-30 2010-09-30
Unique Award Key CONT_AWD_DTSL5510AP0064D_6947_DTSL5510AP0064_6947
Awarding Agency Department of Transportation
Link View Page

Description
Title MEDICAL SERVICES SERVED AS CORPORATION DOCTOR.
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q526: MEDICAL/PSYCH CONSULTATION SVCS

Recipient Details
Recipient NORTH COUNTRY ADULT MEDICINE, PLLC
UEI EJHLN6ZLNZN5
Legacy DUNS 607831562
Recipient Address UNITED STATES, 38 HOSPITAL DR, MASSENA, 136622201

Related by officers

No related officers

Related by address

38 HOSPITAL DRIVE, MASSENA, NY, United States, 13662

JUST PROPERTIES, LLC NORTH COUNTRY IPA, INC. NORTH COUNTRY MEDICAL MANAGEMENT LLC

Date of last update: 10 Nov 2024

Sources: New York Secretary of State

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