Search icon

PINE BUSH MENTAL HEALTH, LLP

Company Details

Name: PINE BUSH MENTAL HEALTH, LLP
Jurisdiction: New York
Legal type: DOMESTIC REGISTERED LIMITED LIABILITY PARTNERSHIP
Status: Active
Date of registration: 14 Jan 2000 (25 years ago)
Entity Number: 2461989
ZIP code: 12205
County: Blank
Place of Formation: New York
Address: 1A PINE WEST PLAZA, ALBANY, NY, United States, 12205

Agent

Name Role Address
DAVID E. KAPLAN, M.D. Agent 1A PINE WEST PLAZA, ALBANY, NY, 12205

DOS Process Agent

Name Role Address
THE PARTNERSHIP DOS Process Agent 1A PINE WEST PLAZA, ALBANY, NY, United States, 12205

National Provider Identifier

NPI Number:
1962572362

Authorized Person:

Name:
DR. PATRICIA POLANIK MILLER
Role:
LICENSED PSYCHOLOGIST
Phone:

Taxonomy:

Selected Taxonomy:
103TC0700X - Clinical Psychologist
Is Primary:
Yes

Contacts:

Fax:
5188621668

Form 5500 Series

Employer Identification Number (EIN):
141610524
Plan Year:
2022
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
7
Sponsors Telephone Number:

Filings

Filing Number Date Filed Type Effective Date
191120002051 2019-11-20 FIVE YEAR STATEMENT 2020-01-01
141117002073 2014-11-17 FIVE YEAR STATEMENT 2015-01-01
091208002049 2009-12-08 FIVE YEAR STATEMENT 2010-01-01
041202002507 2004-12-02 FIVE YEAR STATEMENT 2005-01-01
000327000427 2000-03-27 AFFIDAVIT OF PUBLICATION 2000-03-27

Date of last update: 31 Mar 2025

Sources: New York Secretary of State