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ANNE M. KELLY, M.D., P.C.

ANNE M. KELLY, M.D., P.C.

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Company Details

Name:	ANNE M. KELLY, M.D., P.C.
Jurisdiction:	New York
Legal type:	DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status:	Active
Date of registration:	05 Jun 2001 (24 years ago)
Entity Number:	2646723
ZIP code:	11530
County:	Nassau
Place of Formation:	New York
Address:	377 OAK STREET, SUITE 407, GARDEN CITY, NY, United States, 11530
Principal Address:	333 EARLE OVINGTON BLVD, UNIONDALE, NY, United States, 11553

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name	Role	Address
ANNE M KELLY MD	Chief Executive Officer	333 EARLE OVINGTON BLVD, UNIONDALE, NY, United States, 11553

DOS Process Agent

Name	Role	Address
C/O ANNA M. BOUTZALIS, CPA, P.C.	DOS Process Agent	377 OAK STREET, SUITE 407, GARDEN CITY, NY, United States, 11530

National Provider Identifier

NPI Number:

1578738100

Link:

View on NPI website

Authorized Person:

Name:

PETER MCKINNON

Role:

BILLING MANAGER

Phone:

9142449530

Taxonomy:

Selected Taxonomy:

207X00000X - Orthopaedic Surgery Physician

Is Primary:

Yes

Contacts:

Phone:

+1 516-357-8208

Fax:

5162226893

Form 5500 Series

Employer Identification Number (EIN):

113611562

Plan Year:

2024

Number Of Participants:

2

Sponsors Telephone Number:

5163578208

File:

Plan Year:

2023

Number Of Participants:

2

Sponsors Telephone Number:

5163578208

File:

Plan Year:

2022

Number Of Participants:

2

Sponsors Telephone Number:

5163578208

File:

Plan Year:

2021

Number Of Participants:

2

Sponsors Telephone Number:

5163578208

File:

Plan Year:

2020

Number Of Participants:

2

Sponsors Telephone Number:

5163578208

File:

History

Start date	End date	Type	Value
2023-06-01	2023-06-01	Address	333 EARLE OVINGTON BLVD, UNIONDALE, NY, 11553, USA (Type of address: Chief Executive Officer)
2007-06-27	2023-06-01	Address	600 OLD COUNTRY ROAD, SUITE 230, GARDEN CITY, NY, 11530, USA (Type of address: Service of Process)
2005-08-05	2023-06-01	Address	333 EARLE OVINGTON BLVD, UNIONDALE, NY, 11553, USA (Type of address: Chief Executive Officer)
2003-06-11	2005-08-05	Address	333 EARLE OVINGTON BLVD, STE 106, UNIONDALE, NY, 11553, USA (Type of address: Chief Executive Officer)
2003-06-11	2005-08-05	Address	125 15TH ST, GARDEN CITY, NY, 11530, USA (Type of address: Principal Executive Office)

Filings

Filing Number	Date Filed	Type	Effective Date
230601001934	2023-06-01	BIENNIAL STATEMENT	2023-06-01
210601061683	2021-06-01	BIENNIAL STATEMENT	2021-06-01
130607006566	2013-06-07	BIENNIAL STATEMENT	2013-06-01
110629002627	2011-06-29	BIENNIAL STATEMENT	2011-06-01
090629002356	2009-06-29	BIENNIAL STATEMENT	2009-06-01

Paycheck Protection Program

Jobs Reported:

6

Initial Approval Amount:

$56,100

Date Approved:

2020-05-05

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$56,100

Race:

White

Ethnicity:

Not Hispanic or Latino

Gender:

Female Owned

Veteran:

Non-Veteran

Forgiveness Amount:

$56,622.04

Servicing Lender:

Citibank, N.A.

Use of Proceeds:

Payroll: $56,100

Jobs Reported:

2

Initial Approval Amount:

$56,100

Date Approved:

2021-03-23

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$56,100

Race:

White

Ethnicity:

Not Hispanic or Latino

Gender:

Female Owned

Veteran:

Non-Veteran

Forgiveness Amount:

$56,355.57

Servicing Lender:

Citibank, N.A.

Use of Proceeds:

Payroll: $56,097
Utilities: $1

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Date of last update: 30 Mar 2025

Sources: New York Secretary of State