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MID-SUFFOLK PEDIATRIC ASSOCIATES, P.C.

Company Details

Name: MID-SUFFOLK PEDIATRIC ASSOCIATES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 23 Apr 1991 (34 years ago)
Date of dissolution: 22 Sep 2017
Entity Number: 1542339
ZIP code: 11749
County: Suffolk
Place of Formation: New York
Address: 1770 MOTOR PARKWAY, HAUPPAUGE (ISLANDIA), NY, United States, 11749

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 1770 MOTOR PARKWAY, HAUPPAUGE (ISLANDIA), NY, United States, 11749

Chief Executive Officer

Name Role Address
STUART BERMAN MD Chief Executive Officer 1770 MOTOR PARKWAY, HAUPPAUGE (ISLANDIA), NY, United States, 11749

National Provider Identifier

NPI Number:
1891886594

Authorized Person:

Name:
MRS. SUSAN BURGESS
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
Yes

Contacts:

Fax:
6312323481

Form 5500 Series

Employer Identification Number (EIN):
113060544
Plan Year:
2015
Number Of Participants:
94
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
55
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
100
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
86
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
99
Sponsors Telephone Number:

History

Start date End date Type Value
2004-02-24 2005-06-13 Address 1770 MOTOR PARKWAY, HAUPPAUGE (ISLANDIA), NY, 11749, 5260, USA (Type of address: Chief Executive Officer)
2004-02-24 2005-06-13 Address 1770 MOTOR PARKWAY, HAUPPAUGE, NY, 11749, 5260, USA (Type of address: Principal Executive Office)
1999-07-21 2005-06-13 Address 1770 MOTOR PARKWAY, HAUPPAGE, NY, 11788, USA (Type of address: Service of Process)
1991-04-23 1999-07-21 Address 515 ROUTE 111, SMITHTOWN, NY, 11787, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
170922000518 2017-09-22 CERTIFICATE OF DISSOLUTION 2017-09-22
170405006413 2017-04-05 BIENNIAL STATEMENT 2017-04-01
150402006649 2015-04-02 BIENNIAL STATEMENT 2015-04-01
130410006500 2013-04-10 BIENNIAL STATEMENT 2013-04-01
110502002801 2011-05-02 BIENNIAL STATEMENT 2011-04-01

Date of last update: 15 Mar 2025

Sources: New York Secretary of State