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FUSION PHYSICAL THERAPY AND SPORTS WELLNESS, P.C.

FUSION PHYSICAL THERAPY AND SPORTS WELLNESS, P.C.

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Company Details

Name:	FUSION PHYSICAL THERAPY AND SPORTS WELLNESS, P.C.
Jurisdiction:	New York
Legal type:	DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status:	Active
Date of registration:	24 Dec 2002 (23 years ago)
Entity Number:	2849081
ZIP code:	10014
County:	New York
Place of Formation:	New York
Address:	407 W 13TH ST, STE 3B, NEW YORK, NY, United States, 10014

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name	Role	Address
THE CORPORATION	DOS Process Agent	407 W 13TH ST, STE 3B, NEW YORK, NY, United States, 10014

Chief Executive Officer

Name	Role	Address
CAROLYN S MAZUR	Chief Executive Officer	407 W 13TH ST, STE 3B, NEW YORK, NY, United States, 10014

National Provider Identifier

NPI Number:

1316927627

Link:

View on NPI website

Authorized Person:

Name:

CAROLYN S. MAZUR

Role:

CLINICAL DIRECTOR

Phone:

2129244920

Taxonomy:

Selected Taxonomy:

225100000X - Physical Therapist

Is Primary:

Yes

Contacts:

Phone:

+1 212-924-4920

Fax:

2129240225

Form 5500 Series

Employer Identification Number (EIN):

611434733

Plan Year:

2017

Number Of Participants:

49

Sponsors Telephone Number:

2129244920

File:

Plan Year:

2017

Number Of Participants:

40

Sponsors Telephone Number:

2129244920

File:

Plan Year:

2016

Number Of Participants:

32

Sponsors Telephone Number:

2129244920

File:

Plan Year:

2015

Number Of Participants:

24

Sponsors Telephone Number:

2129244920

File:

Plan Year:

2014

Number Of Participants:

15

Sponsors Telephone Number:

2129244920

File:

History

Start date	End date	Type	Value
2021-10-20	2024-05-16	Shares	Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2005-01-19	2011-02-07	Address	407 W 13TH ST, STE 3B, NEW YORK, NY, 10014, USA (Type of address: Principal Executive Office)
2002-12-24	2021-10-20	Shares	Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2002-12-24	2011-02-07	Address	407 WEST 13TH STREET, SUITE 3B, NEW YORK, NY, 10014, USA (Type of address: Service of Process)

Filings

Filing Number	Date Filed	Type	Effective Date
110207002816	2011-02-07	BIENNIAL STATEMENT	2010-12-01
081212002374	2008-12-12	BIENNIAL STATEMENT	2008-12-01
061208002843	2006-12-08	BIENNIAL STATEMENT	2006-12-01
050119002114	2005-01-19	BIENNIAL STATEMENT	2004-12-01
021224000231	2002-12-24	CERTIFICATE OF INCORPORATION	2002-12-24

Paycheck Protection Program

Jobs Reported:

15

Initial Approval Amount:

$218,860

Date Approved:

2021-01-25

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$218,860

Race:

White

Ethnicity:

Not Hispanic or Latino

Gender:

Male Owned

Veteran:

Non-Veteran

Forgiveness Amount:

$221,210.5

Servicing Lender:

Flushing Bank

Use of Proceeds:

Payroll: $218,859

Jobs Reported:

17

Initial Approval Amount:

$185,229

Date Approved:

2020-04-27

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$185,229

Race:

White

Ethnicity:

Not Hispanic or Latino

Gender:

Male Owned

Veteran:

Non-Veteran

Forgiveness Amount:

$187,507.57

Servicing Lender:

Wells Fargo Bank, National Association

Use of Proceeds:

Payroll: $185,229

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Date of last update: 30 Mar 2025

Sources: New York Secretary of State