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LAKE PLAINS MEDICAL PLLC

Company Details

Name: LAKE PLAINS MEDICAL PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 18 Dec 1996 (28 years ago)
Entity Number: 2094008
ZIP code: 14103
County: Orleans
Place of Formation: New York
Address: 100 OHIO STREET, MEDINA, NY, United States, 14103

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 100 OHIO STREET, MEDINA, NY, United States, 14103

National Provider Identifier

NPI Number:
1508920117

Authorized Person:

Name:
THOMAS J MADEJSKI
Role:
MEDICAL DIRECTOR OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No

Contacts:

Fax:
5857983416

Form 5500 Series

Employer Identification Number (EIN):
161531938
Plan Year:
2012
Number Of Participants:
1
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
1
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
22
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
20
Sponsors Telephone Number:

History

Start date End date Type Value
1998-12-16 2000-11-30 Address 100 OHIO STREET, MEDINA, NY, 14103, USA (Type of address: Service of Process)
1996-12-18 1998-12-16 Address 100 OHIO STREET, MEDINA, NY, 14103, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
081121002071 2008-11-21 BIENNIAL STATEMENT 2008-12-01
061201002220 2006-12-01 BIENNIAL STATEMENT 2006-12-01
041227002146 2004-12-27 BIENNIAL STATEMENT 2004-12-01
021202002008 2002-12-02 BIENNIAL STATEMENT 2002-12-01
001130002262 2000-11-30 BIENNIAL STATEMENT 2000-12-01

Date of last update: 14 Mar 2025

Sources: New York Secretary of State