Home Page
Counties
Nassau
11560
NORTH SHORE MEDICAL REHABILITATION, P.C.

NORTH SHORE MEDICAL REHABILITATION, P.C.

Is this your business?

Get access!

Company Details

Name:	NORTH SHORE MEDICAL REHABILITATION, P.C.
Jurisdiction:	New York
Legal type:	DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status:	Active
Date of registration:	12 Sep 2000 (25 years ago)
Entity Number:	2551596
ZIP code:	11560
County:	Nassau
Place of Formation:	New York
Address:	8 THE KNLS, LOCUST VALLEY, NY, United States, 11560
Principal Address:	25 WILLET AVENUE, HICKSVILLE, NY, United States, 11801

Contact Details

Phone +1 718-651-4500

Phone +1 718-441-5700

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name	Role	Address
NORTH SHORE MEDICAL REHABILITATION, P.C.	DOS Process Agent	8 THE KNLS, LOCUST VALLEY, NY, United States, 11560

Chief Executive Officer

Name	Role	Address
GLENN JAKOBSEN DO	Chief Executive Officer	83-71 116TH ST., STE M2, RICHMOND HILL, NY, United States, 11418

National Provider Identifier

NPI Number:

1508897273

Link:

View on NPI website

Authorized Person:

Name:

DR. GLENN JAKOBSEN

Role:

OWNER/PRESIDENT

Phone:

7184415700

Taxonomy:

Selected Taxonomy:

208100000X - Physical Medicine & Rehabilitation Physician

Is Primary:

Yes

Contacts:

Phone:

+1 718-441-5700

Fax:

7184415337

Form 5500 Series

Employer Identification Number (EIN):

113572061

Plan Year:

2020

Number Of Participants:

7

Sponsors Telephone Number:

5166260653

File:

Plan Year:

2020

Number Of Participants:

11

Sponsors Telephone Number:

5162009088

File:

Plan Year:

2019

Number Of Participants:

11

Sponsors Telephone Number:

5162009088

File:

Plan Year:

2018

Number Of Participants:

11

Sponsors Telephone Number:

5162009088

File:

Plan Year:

2017

Number Of Participants:

14

Sponsors Telephone Number:

5162009088

File:

History

Start date	End date	Type	Value
2016-09-14	2018-09-11	Address	969 RIPLEY LN, STE B, OYSTER BAY, NY, 11771, USA (Type of address: Service of Process)
2010-02-17	2020-10-13	Address	40-05 68TH STREET, STE B, WOODSIDE, NY, 11377, USA (Type of address: Chief Executive Officer)
2010-02-17	2016-09-14	Address	40-05 68TH STREET, STE B, WOODSIDE, NY, 11377, USA (Type of address: Service of Process)
2000-09-12	2010-02-17	Address	265 POST AVENUE, SUITE 100, WESTBURY, NY, 11590, USA (Type of address: Service of Process)

Filings

Filing Number	Date Filed	Type	Effective Date
201013060515	2020-10-13	BIENNIAL STATEMENT	2020-09-01
180911006219	2018-09-11	BIENNIAL STATEMENT	2018-09-01
160914006037	2016-09-14	BIENNIAL STATEMENT	2016-09-01
140929006395	2014-09-29	BIENNIAL STATEMENT	2014-09-01
120914006078	2012-09-14	BIENNIAL STATEMENT	2012-09-01

Paycheck Protection Program

Jobs Reported:

3

Initial Approval Amount:

$64,377.14

Date Approved:

2020-04-29

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$64,377.14

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$65,057.95

Servicing Lender:

Square Capital, LLC

Use of Proceeds:

Payroll: $48,282.85
Utilities: $16,094.29

Jobs Reported:

7

Initial Approval Amount:

$64,377.14

Date Approved:

2021-03-08

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$64,377.14

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$64,870.99

Servicing Lender:

Square Capital, LLC

Use of Proceeds:

Payroll: $64,373.14
Utilities: $1

Reviews Leave a review

This company hasn't received any reviews.

Date of last update: 30 Mar 2025

Sources: New York Secretary of State