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PECONIC ANESTHESIOLOGIST, P.C.

Company Details

Name: PECONIC ANESTHESIOLOGIST, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 13 Jul 1995 (30 years ago)
Date of dissolution: 01 Nov 2022
Entity Number: 1938713
ZIP code: 11901
County: Suffolk
Place of Formation: New York
Address: 1900 ROANOKE AVE, RIVERHEAD, NY, United States, 11901

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
ROY R WARD II Chief Executive Officer 1900 ROANOKE AVE, RIVERHEAD, NY, United States, 11901

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 1900 ROANOKE AVE, RIVERHEAD, NY, United States, 11901

National Provider Identifier

NPI Number:
1336167881

Authorized Person:

Name:
DR. ROY WARD
Role:
PRESIDENT OF P.C.
Phone:

Taxonomy:

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

Contacts:

Fax:
6312080988

Form 5500 Series

Employer Identification Number (EIN):
113274225
Plan Year:
2014
Number Of Participants:
15
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
16
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
14
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
7
Sponsors Telephone Number:

History

Start date End date Type Value
1999-08-16 2023-02-07 Address 1900 ROANOKE AVE, RIVERHEAD, NY, 11901, USA (Type of address: Chief Executive Officer)
1999-08-16 2023-02-07 Address 1900 ROANOKE AVE, RIVERHEAD, NY, 11901, USA (Type of address: Service of Process)
1997-07-15 1999-08-16 Address 1300 ROANOKE AVE, RIVERHEAD, NY, 11901, USA (Type of address: Chief Executive Officer)
1997-07-15 1999-08-16 Address 49 HEWITT ROAD, CENTER MORICHES, NY, 11934, USA (Type of address: Principal Executive Office)
1995-07-13 2022-11-01 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
230207003738 2022-11-01 CERTIFICATE OF DISSOLUTION-CANCELLATION 2022-11-01
130812002366 2013-08-12 BIENNIAL STATEMENT 2013-07-01
110811003283 2011-08-11 BIENNIAL STATEMENT 2011-07-01
090727002949 2009-07-27 BIENNIAL STATEMENT 2009-07-01
070802002524 2007-08-02 BIENNIAL STATEMENT 2007-07-01

Date of last update: 14 Mar 2025

Sources: New York Secretary of State