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NORTH SHORE INTERNAL MEDICINE ASSOCIATES, P.C.

Company Details

Name: NORTH SHORE INTERNAL MEDICINE ASSOCIATES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 20 Jul 1972 (53 years ago)
Date of dissolution: 12 Sep 2016
Entity Number: 249534
ZIP code: 11021
County: Nassau
Place of Formation: New York
Address: 560 NORTHERN BLVD STE 203, GREAT NECK, NY, United States, 11021

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 560 NORTHERN BLVD STE 203, GREAT NECK, NY, United States, 11021

Chief Executive Officer

Name Role Address
MICHAEL L. COHEN Chief Executive Officer 560 NORTHERN BLVD., GREAT NECK, NY, United States, 11021

National Provider Identifier

NPI Number:
1407939374

Authorized Person:

Name:
JODIE BLOOM-GOLDSTEIN
Role:
BILLING COORDINATOR
Phone:

Taxonomy:

Selected Taxonomy:
207RC0000X - Cardiovascular Disease Physician
Is Primary:
No
Selected Taxonomy:
207RG0100X - Gastroenterology Physician
Is Primary:
No
Selected Taxonomy:
207RP1001X - Pulmonary Disease Physician
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
5168299674

History

Start date End date Type Value
1998-07-22 2010-07-23 Address 560 NORTHERN BLVD, GREAT NECK, NY, 11021, 5100, USA (Type of address: Principal Executive Office)
1996-08-13 2006-06-23 Address 16 VANAD DRIVE, ROSLYN, NY, 11576, 2527, USA (Type of address: Service of Process)
1995-04-07 1998-07-22 Address 560 NORTHERN BLVD., GREAT NECK, NY, 11021, 5100, USA (Type of address: Principal Executive Office)
1995-04-07 1996-08-13 Address 535 PLANDOME ROAD, MANHASSET, NY, 11030, USA (Type of address: Service of Process)
1972-07-20 1995-04-07 Address 535 PLANDOME RD., MANHASSET, NY, 11030, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
160912000604 2016-09-12 CERTIFICATE OF DISSOLUTION 2016-09-12
120807002347 2012-08-07 BIENNIAL STATEMENT 2012-07-01
100723002839 2010-07-23 BIENNIAL STATEMENT 2010-07-01
080722002415 2008-07-22 BIENNIAL STATEMENT 2008-07-01
060623002810 2006-06-23 BIENNIAL STATEMENT 2006-07-01

Date of last update: 18 Mar 2025

Sources: New York Secretary of State