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ISLAND EMERGENCY MEDICAL SERVICES, P.C.

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Company Details

Name: ISLAND EMERGENCY MEDICAL SERVICES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 09 Mar 2000 (25 years ago)
Entity Number: 2483630
ZIP code: 12207
County: Nassau
Place of Formation: New York
Principal Address: 4535 DRESSLER RD NW, CANTON, OH, United States, 44718
Address: 80 STATE STREET, ALBANY, NY, United States, 12207

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
ANDREW JENIS, M.D. Chief Executive Officer 4535 DRESSLER RD NW, SUITE 200, CANTON, OH, United States, 44718

Agent

Name Role Address
CORPORATION SERVICE COMPANY Agent 80 STATE STREET, ALBANY, NY, 12207

DOS Process Agent

Name Role Address
C/O CORPORATION SERVICE COMPANY DOS Process Agent 80 STATE STREET, ALBANY, NY, United States, 12207

Unique Entity ID

Unique Entity ID:
WJYSWRMB9WB9
CAGE Code:
92DF5
UEI Expiration Date:
2022-07-17

Business Information

Activation Date:
2021-06-23
Initial Registration Date:
2021-06-03

Commercial and government entity program

CAGE number:
92DF5
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2024-03-03
CAGE Expiration:
2026-06-23
SAM Expiration:
2022-07-17

Contact Information

POC:
TOLULOPE HOLLOWAY

National Provider Identifier

NPI Number:
1629274808

Authorized Person:

Name:
DANIEL FERRARA
Role:
OWNER MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
207P00000X - Emergency Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
3045232241

History

Start date End date Type Value
2025-06-28 2025-07-21 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-11-26 2025-06-28 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-10-25 2024-10-25 Address 12420 MILESTONE CENTER DRIVE, SUITE 200, GERMANTOWN, MD, 20876, USA (Type of address: Chief Executive Officer)
2024-10-25 2024-11-26 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-10-25 2024-10-25 Address 4535 DRESSLER RD NW, SUITE 200, CANTON, OH, 44718, USA (Type of address: Chief Executive Officer)

Filings

Filing Number Date Filed Type Effective Date
241025000885 2024-10-25 AMENDMENT TO BIENNIAL STATEMENT 2024-10-25
240302000659 2024-03-02 BIENNIAL STATEMENT 2024-03-02
220303000271 2022-03-03 BIENNIAL STATEMENT 2022-03-01
200303060614 2020-03-03 BIENNIAL STATEMENT 2020-03-01
200210060505 2020-02-10 BIENNIAL STATEMENT 2018-03-01

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Date of last update: 31 Mar 2025

Sources: New York Secretary of State