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MAPLE MEDICAL SERVICES, P.C.

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Company Details

Name: MAPLE MEDICAL SERVICES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 03 Apr 1998 (27 years ago)
Entity Number: 2245974
ZIP code: 14221
County: Erie
Place of Formation: New York
Address: 41 MAPLE RD., WILLIAMSVILLE, NY, United States, 14221
Principal Address: 41 MAPLE RD, WILLIAMSVILLE, NY, United States, 14221

Contact Details

Phone +1 716-631-1045

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
THEODORE G. COSTICH, MD, FACOG Chief Executive Officer 41 MAPLE RD, WILLIAMSVILLE, NY, United States, 14221

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 41 MAPLE RD., WILLIAMSVILLE, NY, United States, 14221

National Provider Identifier

NPI Number:
1871589861

Authorized Person:

Name:
THEODORE GERARD COSTICH
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207V00000X - Obstetrics & Gynecology Physician
Is Primary:
No
Selected Taxonomy:
207VX0000X - Obstetrics Physician
Is Primary:
No

Contacts:

Fax:
7166311365

Form 5500 Series

Employer Identification Number (EIN):
161547361
Plan Year:
2023
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
12
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
13
Sponsors Telephone Number:

History

Start date End date Type Value
2000-04-24 2002-04-04 Address 61 MAPLE ROAD, WILLIAMSVILLE, NY, 14221, USA (Type of address: Chief Executive Officer)
2000-04-24 2002-04-04 Address 61 MAPLE ROAD, WILLIAMSVILLE, NY, 14221, USA (Type of address: Principal Executive Office)
1998-04-03 2002-04-04 Address 5887 BENT BROOK COURT, EAST AMHERST, NY, 14051, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
120531002133 2012-05-31 BIENNIAL STATEMENT 2012-04-01
100512002429 2010-05-12 BIENNIAL STATEMENT 2010-04-01
080425002143 2008-04-25 BIENNIAL STATEMENT 2008-04-01
060530002686 2006-05-30 BIENNIAL STATEMENT 2006-04-01
051115000758 2005-11-15 CERTIFICATE OF AMENDMENT 2005-11-15

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Date of last update: 31 Mar 2025

Sources: New York Secretary of State