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FREDRIC J. MINTZ, M.D., P.C.

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Company Details

Name: FREDRIC J. MINTZ, M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 12 Apr 2002 (23 years ago)
Entity Number: 2754383
ZIP code: 10028
County: Nassau
Place of Formation: New York
Address: 11 EAST 86TH ST, APT 8C, NEW YORK, NY, United States, 10028

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
FREDRIC J MINTZ, MD DOS Process Agent 11 EAST 86TH ST, APT 8C, NEW YORK, NY, United States, 10028

Chief Executive Officer

Name Role Address
FREDRIC J MINTZ, MD Chief Executive Officer 175 JERICHO TPKE, STE 217, SYOSSET, NY, United States, 11791

National Provider Identifier

NPI Number:
1457534141

Authorized Person:

Name:
DR. FREDRIC J MINTZ
Role:
DOCTOR
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
5166820004

Form 5500 Series

Employer Identification Number (EIN):
030432581
Plan Year:
2024
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
17
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
17
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
6
Sponsors Telephone Number:

History

Start date End date Type Value
2012-06-05 2014-06-18 Address 175 JERICHO TURNPIKE, STE 217, SYOSSET, NY, 11791, USA (Type of address: Chief Executive Officer)
2004-04-20 2012-06-05 Address 175 JERICHO TURNPIKE, SUITE 217, SYOSSET, NY, 11791, USA (Type of address: Chief Executive Officer)
2004-04-20 2012-06-05 Address 11 EAST 86TH ST APT 8C, NEW YORK, NY, 10028, USA (Type of address: Principal Executive Office)
2004-04-20 2012-06-05 Address 11 EAST 86TH ST APT 8C, NEW YORK, NY, 10028, USA (Type of address: Service of Process)
2002-04-12 2004-04-20 Address 20 FIR DRIVE, GREAT NECK, NY, 11024, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
140618002250 2014-06-18 BIENNIAL STATEMENT 2014-04-01
120605003058 2012-06-05 BIENNIAL STATEMENT 2012-04-01
100422003636 2010-04-22 BIENNIAL STATEMENT 2010-04-01
080411002219 2008-04-11 BIENNIAL STATEMENT 2008-04-01
060419003118 2006-04-19 BIENNIAL STATEMENT 2006-04-01

Paycheck Protection Program

Jobs Reported:
12
Initial Approval Amount:
$110,400
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$110,400
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$111,086.93
Servicing Lender:
Citibank, N.A.
Use of Proceeds:
Payroll: $110,400

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Date of last update: 30 Mar 2025

Sources: New York Secretary of State