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CRYSTAL RUN MEDICAL SERVICES, P.C.

CRYSTAL RUN MEDICAL SERVICES, P.C.

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Company Details

Name:	CRYSTAL RUN MEDICAL SERVICES, P.C.
Jurisdiction:	New York
Legal type:	DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status:	Active
Date of registration:	29 Mar 1990 (35 years ago)
Entity Number:	1434798
ZIP code:	10941
County:	Orange
Place of Formation:	New York
Principal Address:	236 CRYSTAL RUN RD, MIDDLETOWN, NY, United States, 10941
Address:	236 CRYSTAL RUN RD, BUILDING A, SUITE 204, MIDDLETOWN, NY, United States, 10941

Contact Details

Phone +1 212-734-6621

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name	Role	Address
RAYMOND S BASRI MD	DOS Process Agent	236 CRYSTAL RUN RD, BUILDING A, SUITE 204, MIDDLETOWN, NY, United States, 10941

Agent

Name	Role	Address
RAYMOND BASRI, MD	Agent	61 HIGHLAND AVENUE, MIDDLETOWN, NY

Chief Executive Officer

Name	Role	Address
RAYMOND S BASRI MD	Chief Executive Officer	236 CRYSTAL RUN RD, MIDDLETOWN, NY, United States, 10941

National Provider Identifier

NPI Number:

1104921139

Link:

View on NPI website

Authorized Person:

Name:

RAYMOND S BASRI

Role:

OWNER

Phone:

8456923100

Taxonomy:

Selected Taxonomy:

207R00000X - Internal Medicine Physician

Is Primary:

Yes

Contacts:

Phone:

+1 845-692-3100

Fax:

8456922402

Form 5500 Series

Employer Identification Number (EIN):

061297050

Plan Year:

2023

Number Of Participants:

6

Sponsors Telephone Number:

8456923100

File:

Plan Year:

2023

Number Of Participants:

5

Sponsors Telephone Number:

8456923100

File:

Plan Year:

2022

Number Of Participants:

5

Sponsors Telephone Number:

8456923100

File:

Plan Year:

2022

Number Of Participants:

5

Sponsors Telephone Number:

8456923100

File:

History

Start date	End date	Type	Value
2000-03-20	2018-11-08	Address	236 CRYSTAL RUN RD, MIDDLETOWN, NY, 10941, USA (Type of address: Service of Process)
1994-09-16	2000-03-20	Address	170 CRYSTAL RUN ROAD, MIDDLETOWN, NY, 10940, USA (Type of address: Chief Executive Officer)
1994-09-16	2000-03-20	Address	170 CRYSTAL RUN ROAD, MIDDLETOWN, NY, 10940, USA (Type of address: Principal Executive Office)
1994-09-16	2000-03-20	Address	170 CRYSTAL RUN ROAD, MIDDLETOWN, NY, 10940, USA (Type of address: Service of Process)
1990-03-29	1994-09-16	Address	61 HIGHLAND AVENUE, MIDDLETOWN, NY, 10940, USA (Type of address: Service of Process)

Filings

Filing Number	Date Filed	Type	Effective Date
181108006616	2018-11-08	BIENNIAL STATEMENT	2018-03-01
140514002382	2014-05-14	BIENNIAL STATEMENT	2014-03-01
120425002142	2012-04-25	BIENNIAL STATEMENT	2012-03-01
100407002397	2010-04-07	BIENNIAL STATEMENT	2010-03-01
080313003268	2008-03-13	BIENNIAL STATEMENT	2008-03-01

USAspending Awards / Financial Assistance

Date:

2020-05-02

Link:

View on USAspending

Awarding Agency Name:

Small Business Administration

Transaction Description:

ECONOMIC INJURY DISASTER GRANT

Obligated Amount:

8000.00

Face Value Of Loan:

0.00

Total Face Value Of Loan:

0.00

Date:

2020-04-27

Link:

View on USAspending

Awarding Agency Name:

Small Business Administration

Transaction Description:

TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.

Obligated Amount:

0.00

Face Value Of Loan:

70100.00

Total Face Value Of Loan:

70100.00

Paycheck Protection Program

Jobs Reported:

8

Initial Approval Amount:

$70,100

Date Approved:

2020-04-27

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$70,100

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$70,999.62

Servicing Lender:

ConnectOne Bank

Use of Proceeds:

Payroll: $70,100

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Date of last update: 16 Mar 2025

Sources: New York Secretary of State