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PETER A. KLEIN, M.D., F.A.A.D., P.C.

PETER A. KLEIN, M.D., F.A.A.D., P.C.

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Company Details

Name:	PETER A. KLEIN, M.D., F.A.A.D., P.C.
Jurisdiction:	New York
Legal type:	DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status:	Active
Date of registration:	21 Jan 2003 (23 years ago)
Entity Number:	2859297
ZIP code:	11776
County:	Nassau
Place of Formation:	New York
Address:	6 MEDICAL DRIVE, SUITE D, PORT JEFFERSON STATION, NY, United States, 11776
Principal Address:	6 MEDICAL DRIVE, SUITE D, PT JEFFERSON STATION, NY, United States, 11776

Contact Details

Phone +1 631-928-7922

Phone +1 631-223-4599

Phone +1 631-475-8249

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name	Role	Address
PETER A. KLEIN, M.D., F.A.A.D., P.C.	DOS Process Agent	6 MEDICAL DRIVE, SUITE D, PORT JEFFERSON STATION, NY, United States, 11776

Chief Executive Officer

Name	Role	Address
PETER A KLEIN	Chief Executive Officer	6 MEDICAL DRIVE, SUITE D, PT JEFFERSON STATION, NY, United States, 11776

National Provider Identifier

NPI Number:

1902837396

Link:

View on NPI website

Authorized Person:

Name:

DR. PETER A KLEIN

Role:

PHYSICIAN OWNER

Phone:

6319287922

Taxonomy:

Selected Taxonomy:

207N00000X - Dermatology Physician

Is Primary:

Yes

Contacts:

Phone:

+1 631-928-7922

Fax:

6319289246

Form 5500 Series

Employer Identification Number (EIN):

331039948

Plan Year:

2023

Number Of Participants:

32

Sponsors Telephone Number:

6319287922

File:

Plan Year:

2022

Number Of Participants:

27

Sponsors Telephone Number:

6319287922

File:

Plan Year:

2021

Number Of Participants:

26

Sponsors Telephone Number:

6319287922

File:

Plan Year:

2020

Number Of Participants:

24

Sponsors Telephone Number:

6319287922

File:

Plan Year:

2019

Number Of Participants:

17

Sponsors Telephone Number:

6319287922

File:

History

Start date	End date	Type	Value
2007-01-17	2013-02-11	Address	6 MEDICAL DRIVE, SUITE D, PT JEFFERSON STATION, NY, 11776, USA (Type of address: Chief Executive Officer)
2005-02-14	2007-01-17	Address	20 ROBERT CRESCENT, STONY BROOK, NY, 11790, USA (Type of address: Chief Executive Officer)
2005-02-14	2021-01-04	Address	6 MEDICAL DRIVE, SUITE D, PT JEFFERSON STATION, NY, 11776, USA (Type of address: Service of Process)
2003-01-21	2005-02-14	Address	78 POPLAR STREET, GARDEN CITY, NY, 11530, USA (Type of address: Service of Process)

Filings

Filing Number	Date Filed	Type	Effective Date
210104060332	2021-01-04	BIENNIAL STATEMENT	2021-01-01
190108060616	2019-01-08	BIENNIAL STATEMENT	2019-01-01
170109006664	2017-01-09	BIENNIAL STATEMENT	2017-01-01
150120006078	2015-01-20	BIENNIAL STATEMENT	2015-01-01
130211002295	2013-02-11	BIENNIAL STATEMENT	2013-01-01

Paycheck Protection Program

Jobs Reported:

29

Initial Approval Amount:

$349,417

Date Approved:

2020-04-08

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$349,417

Race:

White

Ethnicity:

Unknown/NotStated

Gender:

Male Owned

Veteran:

Non-Veteran

Forgiveness Amount:

$353,600.43

Servicing Lender:

Bank of America, National Association

Use of Proceeds:

Payroll: $349,417

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Date of last update: 30 Mar 2025

Sources: New York Secretary of State