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PAIN MANAGEMENT & REHABILITATIVE PHYSICAL MEDICINE, P.C.

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Company Details

Name: PAIN MANAGEMENT & REHABILITATIVE PHYSICAL MEDICINE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 02 Dec 1991 (34 years ago)
Entity Number: 1593197
ZIP code: 11581
County: Kings
Place of Formation: New York
Address: 895 CHERRY LN, N WOODMERE, NY, United States, 11581
Principal Address: 2281 82ND STREET, BROOKLYN, NY, United States, 11214

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
LAURIAN JACOBY Chief Executive Officer 895 CHERRY LN, N WOODMERE, NY, United States, 11581

DOS Process Agent

Name Role Address
LAURIAN JACOBY DOS Process Agent 895 CHERRY LN, N WOODMERE, NY, United States, 11581

National Provider Identifier

NPI Number:
1114061074

Authorized Person:

Name:
DR. LAURIAN JACOBY
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
Yes

Contacts:

Fax:
7186210339

Form 5500 Series

Employer Identification Number (EIN):
113087699
Plan Year:
2021
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
5
Sponsors Telephone Number:

History

Start date End date Type Value
2005-02-18 2006-01-19 Address 895 CHERRY LN, N WOODMERE, NY, 11581, USA (Type of address: Principal Executive Office)
1991-12-02 2005-02-18 Address 42-40 BELL BOULEVARD, STE. 401, BAYSIDE, NY, 11361, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
140102002084 2014-01-02 BIENNIAL STATEMENT 2013-12-01
120111003343 2012-01-11 BIENNIAL STATEMENT 2011-12-01
091218002025 2009-12-18 BIENNIAL STATEMENT 2009-12-01
071206003106 2007-12-06 BIENNIAL STATEMENT 2007-12-01
060119003198 2006-01-19 BIENNIAL STATEMENT 2005-12-01

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Date of last update: 15 Mar 2025

Sources: New York Secretary of State