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RAJIV S. SHAH, PHYSICIAN, P.C.

Company Details

Name: RAJIV S. SHAH, PHYSICIAN, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 15 Apr 1988 (37 years ago)
Entity Number: 1253443
ZIP code: 12953
County: Franklin
Place of Formation: New York
Address: 5 CLAY ST, MALONE, NY, United States, 12953

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
RAJIV SHAH MD Chief Executive Officer 5 CLAY ST, MALONE, NY, United States, 12953

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 5 CLAY ST, MALONE, NY, United States, 12953

National Provider Identifier

NPI Number:
1457428559

Authorized Person:

Name:
RAJIV SHAH
Role:
SOLE MEMBER
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes
Selected Taxonomy:
207RG0100X - Gastroenterology Physician
Is Primary:
No

Contacts:

Fax:
3154223909
Fax:
5184831375

Form 5500 Series

Employer Identification Number (EIN):
112904205
Plan Year:
2015
Number Of Participants:
19
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
20
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
20
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
20
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
19
Sponsors Telephone Number:

History

Start date End date Type Value
2002-03-26 2004-05-04 Address 24 FOURTH ST, MALONE, NY, 12953, USA (Type of address: Principal Executive Office)
2002-03-26 2004-05-04 Address 24 FOURTH ST, MALONE, NY, 12953, USA (Type of address: Chief Executive Officer)
2002-03-26 2004-05-04 Address 24 FOURTH ST, MALONE, NY, 12953, USA (Type of address: Service of Process)
1992-12-17 2002-03-26 Address 16 FOURTH STREET, MALONE, NY, 12953, USA (Type of address: Chief Executive Officer)
1992-12-17 2002-03-26 Address 16 FOURTH STREET, MALONE, NY, 12953, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
140702002306 2014-07-02 BIENNIAL STATEMENT 2014-04-01
120723002116 2012-07-23 BIENNIAL STATEMENT 2012-04-01
100617003032 2010-06-17 BIENNIAL STATEMENT 2010-04-01
080508003368 2008-05-08 BIENNIAL STATEMENT 2008-04-01
060428002914 2006-04-28 BIENNIAL STATEMENT 2006-04-01

Date of last update: 16 Mar 2025

Sources: New York Secretary of State