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HAVERSTRAW FAMILY PRACTICE, P.C.

Company Details

Name: HAVERSTRAW FAMILY PRACTICE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 04 Apr 2002 (23 years ago)
Date of dissolution: 12 Aug 2021
Entity Number: 2751409
ZIP code: 10927
County: Rockland
Place of Formation: New York
Address: 61 NEW MAIN ST, STE 101, PO BOX 380, HAVERSTRAW, NY, United States, 10927
Principal Address: 61 NEW MAIN ST, STE 101, HAVERSTRAW, NY, United States, 10927

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 61 NEW MAIN ST, STE 101, PO BOX 380, HAVERSTRAW, NY, United States, 10927

Chief Executive Officer

Name Role Address
JORGE E. LUGO, MD Chief Executive Officer 61 NEW MAIN ST, STE 101, PO BOX 380, HAVERSTRAW, NY, United States, 10927

National Provider Identifier

NPI Number:
1720177694

Authorized Person:

Name:
JORGE ERNESTO LUGO
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
8459424514

History

Start date End date Type Value
2014-07-09 2022-04-01 Address 61 NEW MAIN ST, STE 101, PO BOX 380, HAVERSTRAW, NY, 10927, USA (Type of address: Service of Process)
2014-07-09 2022-04-01 Address 61 NEW MAIN ST, STE 101, PO BOX 380, HAVERSTRAW, NY, 10927, USA (Type of address: Chief Executive Officer)
2006-05-03 2014-07-09 Address 61 NEW MAIN STREET, HAVERSTRAW, NY, 10927, USA (Type of address: Service of Process)
2004-06-08 2014-07-09 Address 61 NEW MAIN ST, HAVERSTRAW, NY, 10927, USA (Type of address: Principal Executive Office)
2004-06-08 2014-07-09 Address 61 NEW MAIN ST, HAVERSTRAW, NY, 10927, USA (Type of address: Chief Executive Officer)

Filings

Filing Number Date Filed Type Effective Date
220401002431 2021-08-12 CERTIFICATE OF DISSOLUTION-CANCELLATION 2021-08-12
140709002386 2014-07-09 BIENNIAL STATEMENT 2014-04-01
120618002812 2012-06-18 BIENNIAL STATEMENT 2012-04-01
100429002520 2010-04-29 BIENNIAL STATEMENT 2010-04-01
080429002265 2008-04-29 BIENNIAL STATEMENT 2008-04-01

Date of last update: 30 Mar 2025

Sources: New York Secretary of State