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MATHEW M. CHACKO, PHYSICIAN, P.C.

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Company Details

Name: MATHEW M. CHACKO, PHYSICIAN, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 16 Jan 1997 (29 years ago)
Entity Number: 2103182
ZIP code: 11787
County: Suffolk
Place of Formation: New York
Principal Address: 319 MIDDLE COUNTRY RD, STE 5, SMITHTOWN, NY, United States, 11787
Address: 319 MIDDLE COUNTRY RD, STE 5, SMITTOWN, NY, United States, 11787

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
MATHEW M. CHACKO, PHYSICIAN, P.C. DOS Process Agent 319 MIDDLE COUNTRY RD, STE 5, SMITTOWN, NY, United States, 11787

Chief Executive Officer

Name Role Address
MATHEW M CHACKO MD Chief Executive Officer 319 MIDDLE COUNTRY RD, STE 5, SMITHTOWN, NY, United States, 11787

National Provider Identifier

NPI Number:
1912163346

Authorized Person:

Name:
DR. MATHEW MELOOTTU CHACKO
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
2084N0400X - Neurology Physician
Is Primary:
Yes

Contacts:

Fax:
6313602815

Form 5500 Series

Employer Identification Number (EIN):
113365517
Plan Year:
2015
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
3
Sponsors Telephone Number:

History

Start date End date Type Value
2011-01-28 2017-01-03 Address 317 MIDDLE COUNTRY RD, STE 1, SMITHTOWN, NY, 11787, USA (Type of address: Chief Executive Officer)
2011-01-28 2017-01-03 Address 317 MIDDLE COUNTRY RD, STE 1, SMITHTOWN, NY, 11787, USA (Type of address: Principal Executive Office)
2011-01-28 2017-01-03 Address 317 MIDDLE COUNTRY RD, STE 1, SMITTOWN, NY, 11787, USA (Type of address: Service of Process)
1999-02-04 2011-01-28 Address 222 EAST MAIN STREET, NEW YORK, NY, 11787, USA (Type of address: Chief Executive Officer)
1999-02-04 2011-01-28 Address 222 EAST MAIN STREET, NEW YORK, NY, 11787, USA (Type of address: Principal Executive Office)

Filings

Filing Number Date Filed Type Effective Date
190109060405 2019-01-09 BIENNIAL STATEMENT 2019-01-01
170103006780 2017-01-03 BIENNIAL STATEMENT 2017-01-01
150113006365 2015-01-13 BIENNIAL STATEMENT 2015-01-01
130122006214 2013-01-22 BIENNIAL STATEMENT 2013-01-01
110128002155 2011-01-28 BIENNIAL STATEMENT 2011-01-01

USAspending Awards / Financial Assistance

Date:
2021-02-05
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:
42095.00
Total Face Value Of Loan:
42095.00
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:
38250.00
Total Face Value Of Loan:
38250.00

Paycheck Protection Program

Jobs Reported:
4
Initial Approval Amount:
$42,095
Date Approved:
2021-02-05
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$42,095
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$42,505.24
Servicing Lender:
JPMorgan Chase Bank, National Association
Use of Proceeds:
Payroll: $42,093
Utilities: $1
Jobs Reported:
4
Initial Approval Amount:
$38,250
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$38,250
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$38,596.74
Servicing Lender:
JPMorgan Chase Bank, National Association
Use of Proceeds:
Payroll: $31,663
Utilities: $1,613
Rent: $3,800
Healthcare: $1174

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Date of last update: 01 Apr 2025

Sources: New York Secretary of State