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VALLEY STREAM MEDICAL ASSOCIATES, P.C.

Company Details

Name: VALLEY STREAM MEDICAL ASSOCIATES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 02 Jun 1997 (28 years ago)
Entity Number: 2148779
ZIP code: 11580
County: Nassau
Place of Formation: New York
Principal Address: 15 FLETCHER AVE, VALLEY STREAM, NY, United States, 11580
Address: 15 Fletcher Ave, 15 Fletcher Ave, Valley Stream NY USA, NY, United States, 11580

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
R. URBANCZYK, MD Chief Executive Officer 15 FLETCHER AVENUE, VALLEY STREAM, NY, United States, 11580

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 15 Fletcher Ave, 15 Fletcher Ave, Valley Stream NY USA, NY, United States, 11580

National Provider Identifier

NPI Number:
1033665013
Certification Date:
2023-11-08

Authorized Person:

Name:
ROMAN PETER URBANCZYK
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
207RP1001X - Pulmonary Disease Physician
Is Primary:
Yes

Contacts:

Fax:
5168725133

History

Start date End date Type Value
2023-07-04 2023-07-04 Address 15 FLETCHER AVENUE, VALLEY STREAM, NY, 11580, USA (Type of address: Chief Executive Officer)
2003-06-27 2023-07-04 Address 15 FLETCHER AVE, VALLEY STREAM, NY, 11580, USA (Type of address: Service of Process)
2001-06-20 2023-07-04 Address 15 FLETCHER AVENUE, VALLEY STREAM, NY, 11580, USA (Type of address: Chief Executive Officer)
1999-07-21 2001-06-20 Address 15 FLETCHER AVE., VALLEY STREAM, NY, 11580, USA (Type of address: Chief Executive Officer)
1997-06-02 2023-07-04 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
230704000874 2023-07-04 BIENNIAL STATEMENT 2023-06-01
230125003137 2023-01-25 BIENNIAL STATEMENT 2021-06-01
130716002048 2013-07-16 BIENNIAL STATEMENT 2013-06-01
110804002905 2011-08-04 BIENNIAL STATEMENT 2011-06-01
090709003150 2009-07-09 BIENNIAL STATEMENT 2009-06-01

Date of last update: 31 Mar 2025

Sources: New York Secretary of State