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SCOTT BLOOM, M.D., P.C.

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Company Details

Name: SCOTT BLOOM, M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 13 Jun 1996 (29 years ago)
Entity Number: 2039052
ZIP code: 11753
County: Nassau
Place of Formation: New York
Address: 99 JERICHO TPKE / SUITE 206, JERICHO, NY, United States, 11753

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 99 JERICHO TPKE / SUITE 206, JERICHO, NY, United States, 11753

Chief Executive Officer

Name Role Address
SCOTT BLOOM Chief Executive Officer 99 JERICHO TPKE / SUITE 206, JERICHO, NY, United States, 11753

National Provider Identifier

NPI Number:
1295824530
Certification Date:
2023-05-29

Authorized Person:

Name:
SCOTT BLOOM
Role:
PRES
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
5163382901

History

Start date End date Type Value
2006-07-21 2010-07-01 Address 99 JERICHO TPKE, STE 206, JERICHO, NY, 11753, USA (Type of address: Service of Process)
2006-07-21 2010-07-01 Address 99 JERICHO TPKE, STE 206, JERICHO, NY, 11753, USA (Type of address: Principal Executive Office)
2006-07-21 2010-07-01 Address 99 JERICHO TPKE, STE 206, JERICHO, NY, 11753, USA (Type of address: Chief Executive Officer)
2002-06-17 2006-07-21 Address 55 POST AVENUE, STE. 201, WESTBURY, NY, 11590, USA (Type of address: Principal Executive Office)
2002-06-17 2006-07-21 Address 55 POST AVENUE, STE 201, WESTBURY, NY, 11590, USA (Type of address: Chief Executive Officer)

Filings

Filing Number Date Filed Type Effective Date
160801006993 2016-08-01 BIENNIAL STATEMENT 2016-06-01
140602006460 2014-06-02 BIENNIAL STATEMENT 2014-06-01
120613006486 2012-06-13 BIENNIAL STATEMENT 2012-06-01
100701003009 2010-07-01 BIENNIAL STATEMENT 2010-06-01
080724002049 2008-07-24 BIENNIAL STATEMENT 2008-06-01

USAspending Awards / Financial Assistance

Date:
2021-03-06
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:
37382.00
Total Face Value Of Loan:
37382.00
Date:
2020-05-02
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:
35585.00
Total Face Value Of Loan:
35585.00

Paycheck Protection Program

Jobs Reported:
4
Initial Approval Amount:
$37,382
Date Approved:
2021-03-06
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$37,382
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$37,587.56
Servicing Lender:
JPMorgan Chase Bank, National Association
Use of Proceeds:
Payroll: $37,379
Utilities: $1
Jobs Reported:
5
Initial Approval Amount:
$35,585
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$35,585
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$35,921.14
Servicing Lender:
JPMorgan Chase Bank, National Association
Use of Proceeds:
Payroll: $31,703
Rent: $3,882

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Date of last update: 14 Mar 2025

Sources: New York Secretary of State