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SOUTH SHORE INFECTIOUS DISEASES, P.C.

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Company Details

Name: SOUTH SHORE INFECTIOUS DISEASES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 22 Jul 1997 (28 years ago)
Entity Number: 2164054
ZIP code: 11747
County: Suffolk
Place of Formation: New York
Principal Address: 786 MONTAUK HWY, WEST ISLIP, NY, United States, 11795
Address: 1895 WALT WHITMAN ROAD, STE 5, MELVILLE, NY, United States, 11747

Contact Details

Phone +1 631-376-6075

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
ADRIANE COLLINS Chief Executive Officer 786 MONTAUK HWY, WEST ISLIP, NY, United States, 11795

DOS Process Agent

Name Role Address
MANZI, PINO & CO PC DOS Process Agent 1895 WALT WHITMAN ROAD, STE 5, MELVILLE, NY, United States, 11747

National Provider Identifier

NPI Number:
1548287360
Certification Date:
2024-01-16

Authorized Person:

Name:
CAROLINA BLANDON
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
174400000X - Specialist
Is Primary:
No
Selected Taxonomy:
207RI0200X - Infectious Disease Physician
Is Primary:
Yes

Contacts:

Fax:
6313766091

Form 5500 Series

Employer Identification Number (EIN):
113391292
Plan Year:
2023
Number Of Participants:
20
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
19
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
20
Sponsors Telephone Number:

History

Start date End date Type Value
2007-09-11 2009-07-20 Address 1818 BELLMORE AVE, BELLMORE, NY, 11710, USA (Type of address: Service of Process)
1997-07-22 2007-09-11 Address ONE HUNTINGTON QUADRANGLE, MELVILLE, NY, 11747, USA (Type of address: Service of Process)
1997-07-22 2024-09-23 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
130916002131 2013-09-16 BIENNIAL STATEMENT 2013-07-01
110819002590 2011-08-19 BIENNIAL STATEMENT 2011-07-01
090720002745 2009-07-20 BIENNIAL STATEMENT 2009-07-01
070911002619 2007-09-11 BIENNIAL STATEMENT 2007-07-01
051013002567 2005-10-13 BIENNIAL STATEMENT 2005-07-01

USAspending Awards / Financial Assistance

Date:
2020-04-29
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:
102600.00
Total Face Value Of Loan:
102600.00

Paycheck Protection Program

Jobs Reported:
35
Initial Approval Amount:
$102,600
Date Approved:
2020-04-29
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$102,600
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$103,721.57
Servicing Lender:
Loan Source Incorporated
Use of Proceeds:
Payroll: $102,600

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Date of last update: 31 Mar 2025

Sources: New York Secretary of State