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WELLWOOD MEDICAL, P.C.

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Company Details

Name: WELLWOOD MEDICAL, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 03 Mar 1995 (30 years ago)
Entity Number: 1899577
ZIP code: 11691
County: Suffolk
Place of Formation: New York
Address: 228 BEACH 20TH ST, FAR ROCKAWAY, NY, United States, 11691

Contact Details

Phone +1 718-471-5554

Shares Details

Shares issued 1000

Share Par Value 1

Type PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 228 BEACH 20TH ST, FAR ROCKAWAY, NY, United States, 11691

Chief Executive Officer

Name Role Address
HILLARY J HURTADO MD Chief Executive Officer 235 EVERIT AVE, HEWLETT HARBOR, NY, United States, 11557

National Provider Identifier

NPI Number:
1457454902

Authorized Person:

Name:
DEBORAH A GRIFFIN
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
7184713940

Form 5500 Series

Employer Identification Number (EIN):
113255506
Plan Year:
2017
Number Of Participants:
3
Sponsors Telephone Number:

History

Start date End date Type Value
1997-04-09 1999-05-18 Address 250 MAIN ST, EAST ROCKAWAY, NY, 11518, USA (Type of address: Chief Executive Officer)
1995-05-31 1997-04-09 Address 224 NORTH WELLWOOD AVENUE, LINDENHURST, NY, 11757, USA (Type of address: Service of Process)
1995-03-03 1995-05-31 Address C/O HILLARY J. HURTADO, M.D., 250 MAIN STREET, EAST ROCKAWAY, NY, 00000, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
030415002275 2003-04-15 BIENNIAL STATEMENT 2003-03-01
010327002282 2001-03-27 BIENNIAL STATEMENT 2001-03-01
990518002345 1999-05-18 BIENNIAL STATEMENT 1999-03-01
970409002589 1997-04-09 BIENNIAL STATEMENT 1997-03-01
950531000609 1995-05-31 CERTIFICATE OF AMENDMENT 1995-05-31

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Date of last update: 14 Mar 2025

Sources: New York Secretary of State