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  5. QUEENS-LONG ISLAND MEDICAL GROUP, P.C.

QUEENS-LONG ISLAND MEDICAL GROUP, P.C.

Company Details

Name: QUEENS-LONG ISLAND MEDICAL GROUP, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 21 Nov 1990 (34 years ago)
Date of dissolution: 31 Dec 2016
Entity Number: 1490391
ZIP code: 10041
County: New York
Place of Formation: New York
Address: 55 WATER STREET, NEW YORK, NY, United States, 10041
Principal Address: ADVANTAGECARE PHYSICIANS, P.C., 55 WATER STREET, NEW YORK, NY, United States, 10041

Shares Details

Shares issued 1500

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
QUEENS LONG ISLAND MEDICAL GROUP P.C.N.Q. LOCAL 153 SAVINGS AND INVESTMENT PLAN 2010 113039101 2011-10-31 QUEENS-LONG ISLAND MEDICAL GROUP, P.C. 109
File View Page
Three-digit plan number (PN) 008
Effective date of plan 1996-10-01
Business code 621111
Sponsor’s telephone number 5165426861
Plan sponsor’s address 1000 ZECKENDORF BLVD, GARDEN CITY, NY, 115300000

Plan administrator’s name and address
Administrator’s EIN 113039101
Plan administrator’s name QUEENS-LONG ISLAND MEDICAL GROUP, P.C.
Plan administrator’s address 1000 ZECKENDORF BLVD, GARDEN CITY, NY, 115300000
Administrator’s telephone number 5165426861

Signature of
Role Plan administrator
Date 2011-10-31
Name of individual signing NIKI KALAITZIS

DOS Process Agent

Name Role Address
QUEENS-LONG ISLAND MEDICAL GROUP, P.C. DOS Process Agent 55 WATER STREET, NEW YORK, NY, United States, 10041

Chief Executive Officer

Name Role Address
NAVARRA RODRIGUEZ, M.D. Chief Executive Officer 55 WATER STREET, NEW YORK, NY, United States, 10041

History

Start date End date Type Value
2015-01-08 2016-10-05 Address 55 WATER STREET, NEW YORK, NY, 10041, USA (Type of address: Chief Executive Officer)
2015-01-08 2016-10-05 Address 55 WATER STREET, NEW YORK, NY, 10041, USA (Type of address: Principal Executive Office)
2013-03-29 2015-01-08 Address C/O EMBLEMHEALTH, 441 NINTH AVENUE, NEW YORK, NY, 10001, USA (Type of address: Service of Process)
2013-01-17 2015-01-08 Address 1000 ZECKENDORF BLVD, GARDEN CITY, NY, 11530, USA (Type of address: Principal Executive Office)
2013-01-17 2015-01-08 Address 1000 ZECKENDORF BLVD, GARDEN CITY, NY, 11530, USA (Type of address: Chief Executive Officer)
2013-01-17 2013-03-29 Address 800 AXINN AVE, GARDEN CITY, NY, 11530, USA (Type of address: Service of Process)
2002-05-29 2013-01-17 Address 106 EAB PLAZA, WEST TOWER, 12TH FLOOR, UNIONDALE, NY, 11556, 0106, USA (Type of address: Service of Process)
2002-05-29 2013-02-21 Shares Share type: NO PAR VALUE, Number of shares: 1500, Par value: 0
1996-11-27 2013-01-17 Address 106 EAB PLAZA, UNIONDALE, NY, 11556, USA (Type of address: Chief Executive Officer)
1996-11-27 2002-05-29 Address 106 EAB PLAZA, UNIONDALE, NY, 11556, 0106, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
161216000136 2016-12-16 CERTIFICATE OF MERGER 2016-12-31
161123006130 2016-11-23 BIENNIAL STATEMENT 2016-11-01
161005002045 2016-10-05 AMENDMENT TO BIENNIAL STATEMENT 2014-11-01
150108006180 2015-01-08 BIENNIAL STATEMENT 2014-11-01
130329000290 2013-03-29 CERTIFICATE OF AMENDMENT 2013-03-29
130221000510 2013-02-21 CERTIFICATE OF AMENDMENT 2013-02-21
130117002200 2013-01-17 BIENNIAL STATEMENT 2012-11-01
020529000454 2002-05-29 CERTIFICATE OF AMENDMENT 2002-05-29
001109002021 2000-11-09 BIENNIAL STATEMENT 2000-11-01
990119002635 1999-01-19 BIENNIAL STATEMENT 1998-11-01

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
109920959 0214700 1994-04-13 226 CLINTON STREET, HEMPSTEAD, NY, 11550
Inspection Type Complaint
Scope Complete
Safety/Health Health
Close Conference 1994-05-02
Case Closed 1994-08-12

Related Activity
Type Complaint
Activity Nr 74088956
Health Yes

Violation Items
Citation ID 01001
Citaton Type Serious
Standard Cited 19101048 M05
Issuance Date 1994-05-27
Abatement Due Date 1994-08-15
Current Penalty 1250.0
Initial Penalty 2500.0
Nr Instances 1
Nr Exposed 1
Gravity 03
Citation ID 01002
Citaton Type Serious
Standard Cited 19101048 N01
Issuance Date 1994-05-27
Abatement Due Date 1994-08-15
Current Penalty 1250.0
Initial Penalty 2500.0
Nr Instances 1
Nr Exposed 4
Gravity 03
Citation ID 02001
Citaton Type Serious
Standard Cited 19040002 A
Issuance Date 1994-05-27
Abatement Due Date 1994-06-09
Current Penalty 1000.0
Initial Penalty 2000.0
Nr Instances 1
Nr Exposed 76
Gravity 01
101486827 0214700 1991-08-12 640 HAWKINS ROAD, RONKONKOMA, NY, 11779
Inspection Type Complaint
Scope Partial
Safety/Health Health
Close Conference 1991-08-12
Emphasis N: BLOOD
Case Closed 1991-08-13

Related Activity
Type Complaint
Activity Nr 74562554
Health Yes
101486843 0214700 1991-08-12 640 HAWKINS ROAD, RONKONKOMA, NY, 11779
Inspection Type FollowUp
Scope Partial
Safety/Health Health
Close Conference 1991-08-12
Emphasis N: BLOOD
Case Closed 1991-08-13

Related Activity
Type Inspection
Activity Nr 101537769
101537769 0214700 1989-07-27 640 HAWKINS ROAD, RONKONKOMA, NY, 11779
Inspection Type Referral
Scope Partial
Safety/Health Health
Close Conference 1989-10-19
Emphasis N: BLOOD
Case Closed 1991-10-29

Related Activity
Type Referral
Activity Nr 901105312
Health Yes

Violation Items
Citation ID 01001
Citaton Type Serious
Standard Cited 5A0001
Issuance Date 1990-01-04
Abatement Due Date 1990-02-28
Current Penalty 450.0
Initial Penalty 900.0
Contest Date 1990-01-25
Final Order 1991-04-25
Nr Instances 1
Nr Exposed 10
Gravity 09
Hazard CHEMICAL
Citation ID 01002
Citaton Type Serious
Standard Cited 19100020 E01 I
Issuance Date 1990-01-04
Abatement Due Date 1990-01-09
Current Penalty 400.0
Initial Penalty 800.0
Contest Date 1990-01-25
Final Order 1991-04-25
Nr Instances 1
Nr Exposed 100
Gravity 08
Citation ID 01003
Citaton Type Serious
Standard Cited 19100020 G01
Issuance Date 1990-01-04
Abatement Due Date 1990-01-16
Current Penalty 400.0
Initial Penalty 800.0
Contest Date 1990-01-25
Final Order 1991-04-25
Nr Instances 1
Nr Exposed 100
Gravity 08
Citation ID 01004
Citaton Type Serious
Standard Cited 19100020 G02
Issuance Date 1990-01-04
Abatement Due Date 1990-01-16
Current Penalty 400.0
Initial Penalty 800.0
Contest Date 1990-01-25
Final Order 1991-04-25
Nr Instances 1
Nr Exposed 100
Gravity 08
Citation ID 01005
Citaton Type Serious
Standard Cited 19100141 A04 I
Issuance Date 1990-01-04
Abatement Due Date 1990-01-09
Current Penalty 450.0
Initial Penalty 900.0
Contest Date 1990-01-25
Final Order 1991-04-25
Nr Instances 1
Nr Exposed 100
Gravity 09
Citation ID 01006
Citaton Type Serious
Standard Cited 19100145 E04
Issuance Date 1990-01-04
Abatement Due Date 1990-01-10
Current Penalty 450.0
Initial Penalty 900.0
Contest Date 1990-01-25
Final Order 1991-04-25
Nr Instances 1
Nr Exposed 100
Gravity 09
Citation ID 01007
Citaton Type Serious
Standard Cited 19101200 E01
Issuance Date 1990-01-04
Abatement Due Date 1990-02-07
Current Penalty 270.0
Initial Penalty 600.0
Contest Date 1990-01-25
Final Order 1991-04-25
Nr Instances 1
Nr Exposed 100
Gravity 06
Citation ID 01008
Citaton Type Serious
Standard Cited 19101200 F05 I
Issuance Date 1990-01-04
Abatement Due Date 1990-01-16
Current Penalty 270.0
Initial Penalty 600.0
Contest Date 1990-01-25
Final Order 1991-04-25
Nr Instances 1
Nr Exposed 100
Gravity 06
Citation ID 01009
Citaton Type Serious
Standard Cited 19101200 F05 II
Issuance Date 1990-01-04
Abatement Due Date 1990-01-16
Current Penalty 270.0
Initial Penalty 600.0
Contest Date 1990-01-25
Final Order 1991-04-25
Nr Instances 1
Nr Exposed 100
Gravity 06
Citation ID 01010
Citaton Type Serious
Standard Cited 19101200 G01
Issuance Date 1990-01-04
Abatement Due Date 1990-02-07
Current Penalty 270.0
Initial Penalty 600.0
Contest Date 1990-01-25
Final Order 1991-04-25
Nr Instances 1
Nr Exposed 100
Gravity 06
Citation ID 01011
Citaton Type Serious
Standard Cited 19101200 H
Issuance Date 1990-01-04
Abatement Due Date 1990-03-07
Current Penalty 270.0
Initial Penalty 600.0
Contest Date 1990-01-25
Final Order 1991-04-25
Nr Instances 1
Nr Exposed 100
Gravity 06
Citation ID 02001
Citaton Type Willful
Standard Cited 5A0001
Issuance Date 1990-01-04
Abatement Due Date 1990-03-07
Current Penalty 5500.0
Initial Penalty 10000.0
Contest Date 1990-01-25
Final Order 1991-04-25
Nr Instances 1
Nr Exposed 100
Gravity 10
Hazard BLOODBORNE
Citation ID 02002
Citaton Type Willful
Standard Cited 19100132 A
Issuance Date 1990-01-04
Abatement Due Date 1990-01-16
Current Penalty 5500.0
Initial Penalty 10000.0
Contest Date 1990-01-25
Final Order 1991-04-25
Nr Instances 1
Nr Exposed 100
Gravity 10
Citation ID 03001
Citaton Type Other
Standard Cited 19030002 A01
Issuance Date 1990-01-04
Abatement Due Date 1990-01-09
Initial Penalty 100.0
Contest Date 1990-01-25
Final Order 1991-04-25
Nr Instances 1
Nr Exposed 100
Citation ID 03002
Citaton Type Other
Standard Cited 19040002 A
Issuance Date 1990-01-04
Abatement Due Date 1990-01-18
Current Penalty 100.0
Initial Penalty 500.0
Contest Date 1990-01-25
Final Order 1991-04-25
Nr Instances 1
Nr Exposed 100

Related by officers

QUEENS-LONG ISLAND MEDICAL GROUP, P.C.

MALTBY-FORMAN COMMUNICATIONS, LTD.

NAVARRA RODRIGUEZ, M.D.

ADVANTAGECARE PHYSICIANS, P.C. CENTRAL BROOKLYN MEDICAL GROUP, P.C. LHHN MEDICAL, P.C. STATEN ISLAND PHYSICIAN PRACTICE, P.C. SIUC MEDICAL, P.C.

Related by address

55 WATER STREET, NEW YORK, NY, United States, 10041

ADVANTAGECARE PHYSICIANS, P.C. CREATIVE DRIVE LLC EMBLEMHEALTH MEDICAL & DENTAL SERVICES, INC. FENICS SOFTWARE, INC. GFI GROUP INC. GFI SECURITIES NY GFI UK GFINET INC. GHI HOME IMPROVMENT INC GHY SERVICE INDUSTRIES LLC

ADVANTAGECARE PHYSICIANS, P.C., 55 WATER STREET, NEW YORK, NY, United States, 10041

CENTRAL BROOKLYN MEDICAL GROUP, P.C.

Date of last update: 15 Mar 2025

Sources: New York Secretary of State

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