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BOHEMIA MEDICAL, P.C.

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Company Details

Name: BOHEMIA MEDICAL, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 18 Nov 1997 (28 years ago)
Entity Number: 2200199
ZIP code: 11716
County: Suffolk
Place of Formation: New York
Principal Address: 4155 Veterans Highway, suite 5, ronkonkoma, NY, United States, 11779
Address: PO Box 157, Bohemia, NY, United States, 11716

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
BOHEMIA MEDICAL, P.C. DOS Process Agent PO Box 157, Bohemia, NY, United States, 11716

Chief Executive Officer

Name Role Address
BOHEMIA MEDICAL, P.C. Chief Executive Officer PO BOX 157, BOHEMIA, NY, United States, 11716

National Provider Identifier

NPI Number:
1063440659
Certification Date:
2024-07-24

Authorized Person:

Name:
BARRY WEIN
Role:
DO
Phone:

Taxonomy:

Selected Taxonomy:
208D00000X - General Practice Physician
Is Primary:
Yes

Contacts:

Fax:
8884871086

History

Start date End date Type Value
2023-06-20 2023-06-20 Address PO BOX 157, BOHEMIA, NY, 11716, USA (Type of address: Chief Executive Officer)
2023-06-20 2023-06-20 Address 273 KNICKERBOCKER AVE., BOHEMIA, NY, 11716, USA (Type of address: Chief Executive Officer)
2013-10-30 2023-06-20 Address 2805 VETERAN'S MEMORIAL HWY, SUITE #8, RONKONKOMA, NY, 11779, USA (Type of address: Service of Process)
2001-11-27 2023-06-20 Address 273 KNICKERBOCKER AVE., BOHEMIA, NY, 11716, USA (Type of address: Chief Executive Officer)
2001-11-27 2013-10-30 Address 273 KNICKERBOCKER AVE., BOHEMIA, NY, 11716, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
230620000240 2023-06-20 BIENNIAL STATEMENT 2021-11-01
131030000962 2013-10-30 CERTIFICATE OF CHANGE 2013-10-30
051209002438 2005-12-09 BIENNIAL STATEMENT 2005-11-01
031104002691 2003-11-04 BIENNIAL STATEMENT 2003-11-01
011127002361 2001-11-27 BIENNIAL STATEMENT 2001-11-01

Paycheck Protection Program

Jobs Reported:
4
Initial Approval Amount:
$24,370
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$24,370
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$24,576.98
Servicing Lender:
Bank of America, National Association
Use of Proceeds:
Payroll: $24,370

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Date of last update: 31 Mar 2025

Sources: New York Secretary of State