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  5. JEFFERSON ANESTHESIOLOGIST SERVICES, P.C.

JEFFERSON ANESTHESIOLOGIST SERVICES, P.C.

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Company Details

Name: JEFFERSON ANESTHESIOLOGIST SERVICES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 16 Feb 1993 (32 years ago)
Entity Number: 1702897
ZIP code: 13601
County: Jefferson
Place of Formation: New York
Address: PO BOX 779, 104 PADDOCK ST / STE 202, WATERTOWN, NY, United States, 13601

Contact Details

Phone +1 315-785-4313

Phone +1 315-785-8509

Phone +1 315-376-5200

Phone +1 315-782-1650

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
JIN QI Chief Executive Officer 104 PADDOCK ST, STE 202, WATERTOWN, NY, United States, 13601

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent PO BOX 779, 104 PADDOCK ST / STE 202, WATERTOWN, NY, United States, 13601

National Provider Identifier

NPI Number:
1508818014
Link:
View on NPI website

Authorized Person:

Name:
MR. BOB HAWTHORNE
Role:
PRESIDENT
Phone:
3157858509

Taxonomy:

Selected Taxonomy:
207L00000X - Anesthesiology Physician
Is Primary:
Yes

Contacts:

Phone:
+1 315-782-4207
Fax:
3157828699
Phone:
+1 315-785-4313
Fax:
3157795114

Form 5500 Series

Employer Identification Number (EIN):
161431831
Plan Year:
2016
Number Of Participants:
28
Sponsors Telephone Number:
3157854395
File:
View File
Plan Year:
2015
Number Of Participants:
31
Sponsors Telephone Number:
3157854395
File:
View File
Plan Year:
2014
Number Of Participants:
28
Sponsors Telephone Number:
3157854395
File:
View File
Plan Year:
2013
Number Of Participants:
28
Sponsors Telephone Number:
3157854395
File:
View File
Plan Year:
2012
Number Of Participants:
31
Sponsors Telephone Number:
3157854395
File:
View File

History

Start date End date Type Value
2007-02-22 2011-02-18 Address 104 PADDOCK ST, SUITE 202, WATERTOWN, NY, 13601, USA (Type of address: Chief Executive Officer)
2005-04-06 2007-02-22 Address PO BOX 779, 1571 WASHINGTON STREET, WATERTOWN, NY, 13601, USA (Type of address: Service of Process)
2005-04-06 2007-02-22 Address PO BOX 779, 1571 WASHINGTON STREET, WATERTOWN, NY, 13601, USA (Type of address: Chief Executive Officer)
2005-04-06 2007-02-22 Address PO BOX 779, 1571 WASHINGTON STREET, WATERTOWN, NY, 13601, USA (Type of address: Principal Executive Office)
2003-03-03 2005-04-06 Address 1571 WASHINGTON STREET, WATERTOWN, NY, 13601, USA (Type of address: Chief Executive Officer)

Filings

Filing Number Date Filed Type Effective Date
110218002217 2011-02-18 BIENNIAL STATEMENT 2011-02-01
090211002232 2009-02-11 BIENNIAL STATEMENT 2009-02-01
070222002140 2007-02-22 BIENNIAL STATEMENT 2007-02-01
050406002590 2005-04-06 BIENNIAL STATEMENT 2005-02-01
030303002842 2003-03-03 BIENNIAL STATEMENT 2003-02-01

USAspending Awards / Financial Assistance

Date:
2021-02-08
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:
621345.00
Total Face Value Of Loan:
621345.00
Date:
2020-04-30
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:
-522490.00
Total Face Value Of Loan:
850000.00

Paycheck Protection Program

Jobs Reported:
19
Initial Approval Amount:
$1,372,490
Date Approved:
2020-04-13
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$850,000
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$859,012.33
Servicing Lender:
KeyBank National Association
Use of Proceeds:
Payroll: $850,000
Jobs Reported:
18
Initial Approval Amount:
$621,345
Date Approved:
2021-02-07
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$621,345
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$627,490.36
Servicing Lender:
KeyBank National Association
Use of Proceeds:
Payroll: $621,345

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Date of last update: 15 Mar 2025

Sources: New York Secretary of State

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