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RAPHAEL REISS, A PHYSICIAN, P.C.

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Company Details

Name: RAPHAEL REISS, A PHYSICIAN, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 01 Jul 1985 (40 years ago)
Entity Number: 1008730
ZIP code: 11375
County: Queens
Place of Formation: New York
Address: 69-05 YELLOWSTONE BLVD, FOREST HILLS, NY, United States, 11375
Principal Address: 69-05 YELLOWSTONE BLVD., FOREST HILLS, NY, United States, 11375

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 69-05 YELLOWSTONE BLVD, FOREST HILLS, NY, United States, 11375

Chief Executive Officer

Name Role Address
RAPHAEL REISS Chief Executive Officer 69-05 YELLOWSTONE BLVD., FOREST HILLS, NY, United States, 11375

National Provider Identifier

NPI Number:
1245323815
Certification Date:
2022-07-18

Authorized Person:

Name:
DR. RAPHAEL REISS
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
174400000X - Specialist
Is Primary:
No
Selected Taxonomy:
207V00000X - Obstetrics & Gynecology Physician
Is Primary:
Yes

Contacts:

Fax:
7182635401

Form 5500 Series

Employer Identification Number (EIN):
112772955
Plan Year:
2023
Number Of Participants:
20
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
22
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
20
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
21
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
21
Sponsors Telephone Number:

History

Start date End date Type Value
1985-07-01 2009-11-05 Address 75-27 175TH STREET, FLUSHING, NY, 11366, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
140127006333 2014-01-27 BIENNIAL STATEMENT 2013-07-01
110816002697 2011-08-16 BIENNIAL STATEMENT 2011-07-01
091105002180 2009-11-05 BIENNIAL STATEMENT 2009-07-01
070803002123 2007-08-03 BIENNIAL STATEMENT 2007-07-01
030707002472 2003-07-07 BIENNIAL STATEMENT 2003-07-01

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Date of last update: 17 Mar 2025

Sources: New York Secretary of State