Search icon

NEWBURGH INTERNAL MEDICINE, P.C.

Company Details

Name: NEWBURGH INTERNAL MEDICINE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 28 Jan 1987 (38 years ago)
Date of dissolution: 01 Apr 2011
Entity Number: 1140083
ZIP code: 12550
County: Orange
Place of Formation: New York
Principal Address: 21 LAUREL AVE, STE 260, CORNWALL, NY, United States, 12518
Address: 873 UNION AVE., POB 1479, NEWBURGH, NY, United States, 12550

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
STEVEN L. TARSHIS, ESQ. DOS Process Agent 873 UNION AVE., POB 1479, NEWBURGH, NY, United States, 12550

Chief Executive Officer

Name Role Address
SUSAN M JENSEN MD Chief Executive Officer 21 LAUREL AVE, STE 260, CORNWALL, NY, United States, 12518

National Provider Identifier

NPI Number:
1033133632

Authorized Person:

Name:
SUSAN M JENSEN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
174400000X - Specialist
Is Primary:
Yes

Contacts:

Fax:
8455611796

Form 5500 Series

Employer Identification Number (EIN):
141688118
Plan Year:
2009
Number Of Participants:
6
Sponsors Telephone Number:

History

Start date End date Type Value
1993-03-04 2007-01-24 Address 308 FULLERTON AVE, NEWBURGH, NY, 12550, 3722, USA (Type of address: Chief Executive Officer)
1993-03-04 2007-01-24 Address 308 FULLERTON AVE, NEWBURGH, NY, 12550, 3722, USA (Type of address: Principal Executive Office)

Filings

Filing Number Date Filed Type Effective Date
110401000240 2011-04-01 CERTIFICATE OF DISSOLUTION 2011-04-01
090203002571 2009-02-03 BIENNIAL STATEMENT 2009-01-01
070124002239 2007-01-24 BIENNIAL STATEMENT 2007-01-01
050207002002 2005-02-07 BIENNIAL STATEMENT 2005-01-01
030103002431 2003-01-03 BIENNIAL STATEMENT 2003-01-01

Date of last update: 16 Mar 2025

Sources: New York Secretary of State