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OBOSA MEDICAL SERVICES, P.C.

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Company Details

Name: OBOSA MEDICAL SERVICES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 06 Jun 2001 (24 years ago)
Entity Number: 2647517
ZIP code: 10901
County: Rockland
Place of Formation: New York
Address: 11 GOLDEN ROAD, MONTEBELLO, NY, United States, 10901
Principal Address: 11 GOLDEN RD, MONTEBELLO, NY, United States, 10901

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 11 GOLDEN ROAD, MONTEBELLO, NY, United States, 10901

Chief Executive Officer

Name Role Address
FRANCIS AGBANKPOLO, MD Chief Executive Officer 11 GOLDEN RD, MONTEBELLO, NY, United States, 10901

National Provider Identifier

NPI Number:
1659639730

Authorized Person:

Name:
DR. FRANCIS O AGBONKPOLO
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
208VP0014X - Interventional Pain Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
9145302320

Form 5500 Series

Employer Identification Number (EIN):
134175816
Plan Year:
2015
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
4
Sponsors Telephone Number:

Filings

Filing Number Date Filed Type Effective Date
030829002035 2003-08-29 BIENNIAL STATEMENT 2003-06-01
010606000793 2001-06-06 CERTIFICATE OF INCORPORATION 2001-06-15

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Date of last update: 30 Mar 2025

Sources: New York Secretary of State