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OTTER CREEK MEDICAL OFFICE, LLP

Company Details

Name: OTTER CREEK MEDICAL OFFICE, LLP
Jurisdiction: New York
Legal type: DOMESTIC REGISTERED LIMITED LIABILITY PARTNERSHIP
Status: Inactive
Date of registration: 18 Mar 1997 (28 years ago)
Date of dissolution: 05 Oct 2018
Entity Number: 2124191
ZIP code: 13045
County: Blank
Place of Formation: New York
Address: 4343 COSMOS HILL RD, CORTLAND, NY, United States, 13045
Principal Address: 2 ELM STREET, MCGRAW, NY, United States, 13101

DOS Process Agent

Name Role Address
C/O M T MASTRUCC DOS Process Agent 4343 COSMOS HILL RD, CORTLAND, NY, United States, 13045

National Provider Identifier

NPI Number:
1164478293

Authorized Person:

Name:
DR. MARY THERESE MASTRUCCI
Role:
PARTNER
Phone:

Taxonomy:

Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
6078364180

Form 5500 Series

Employer Identification Number (EIN):
161525074
Plan Year:
2017
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
6
Sponsors Telephone Number:

History

Start date End date Type Value
2012-04-26 2017-02-17 Address 2 ELM STREET, MCGRAW, NY, 13101, USA (Type of address: Service of Process)
2002-02-19 2012-04-26 Address 141 GROTON AVE, CORTLAND, NY, 13045, 1907, USA (Type of address: Service of Process)
1997-03-18 2002-02-19 Address 141 GROTON AVENUE, CORTLAND, NY, 13045, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
181005000489 2018-10-05 NOTICE OF WITHDRAWAL 2018-10-05
170217002019 2017-02-17 FIVE YEAR STATEMENT 2017-03-01
120426003004 2012-04-26 FIVE YEAR STATEMENT 2012-03-01
070209002195 2007-02-09 FIVE YEAR STATEMENT 2007-03-01
020219002249 2002-02-19 FIVE YEAR STATEMENT 2002-03-01

Date of last update: 31 Mar 2025

Sources: New York Secretary of State