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BAY RIDGE FOURTH AVENUE MEDICAL ASSOCIATES, P.C.

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Company Details

Name: BAY RIDGE FOURTH AVENUE MEDICAL ASSOCIATES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 03 Feb 1992 (33 years ago)
Entity Number: 1608234
ZIP code: 11209
County: Kings
Place of Formation: New York
Address: 441 BAY RIDGE PARKWAY, BROOKLYN, NY, United States, 11209
Principal Address: 648 74TH STREET, BROOKLYN, NY, United States, 11209

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
JEFFREY J BASTI Chief Executive Officer 648 74TH STREET, BROOKLYN, NY, United States, 11209

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 441 BAY RIDGE PARKWAY, BROOKLYN, NY, United States, 11209

National Provider Identifier

NPI Number:
1841370814

Authorized Person:

Name:
DR. JEFFREY J BASTI
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
207RP1001X - Pulmonary Disease Physician
Is Primary:
No
Selected Taxonomy:
207RC0200X - Critical Care Medicine (Internal Medicine) Physician
Is Primary:
Yes

Contacts:

Fax:
7188368113

Form 5500 Series

Employer Identification Number (EIN):
113096855
Plan Year:
2015
Number Of Participants:
18
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
19
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
19
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
20
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
22
Sponsors Telephone Number:

History

Start date End date Type Value
1992-02-03 1994-02-17 Address 648 74TH STREET, BROOKLYN, NY, 11209, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
980223000225 1998-02-23 CERTIFICATE OF MERGER 1998-02-23
980129000484 1998-01-29 CERTIFICATE OF AMENDMENT 1998-01-29
940217002627 1994-02-17 BIENNIAL STATEMENT 1994-02-01
930609002388 1993-06-09 BIENNIAL STATEMENT 1993-02-01
920203000293 1992-02-03 CERTIFICATE OF INCORPORATION 1992-02-03

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Date of last update: 15 Mar 2025

Sources: New York Secretary of State