LONG ISLAND HEALTH AND WELLNESS FAMILY MEDICINE, P.C.

Company Details

Name:	LONG ISLAND HEALTH AND WELLNESS FAMILY MEDICINE, P.C.
Jurisdiction:	New York
Legal type:	DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status:	Inactive
Date of registration:	29 May 2003 (22 years ago)
Date of dissolution:	29 Jun 2016
Entity Number:	2912413
ZIP code:	11701
County:	Suffolk
Place of Formation:	New York
Address:	197 BROADWAY, AMITYVILLE, NY, United States, 11701

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Name	Role	Address
DONATO M BALSAMO	Chief Executive Officer	197 BROADWAY, AMITYVILLE, NY, United States, 11701

Name	Role	Address
THE CORPORATION	DOS Process Agent	197 BROADWAY, AMITYVILLE, NY, United States, 11701

Start date	End date	Type	Value
2006-01-18	2007-06-04	Address	282 A HIEBIE LANE #279, WEST ISLIP, NY, 11795, USA (Type of address: Chief Executive Officer)
2006-01-18	2007-06-04	Address	282 A HIEGIE LANE #279, WEST ISLIP, NY, 11795, USA (Type of address: Principal Executive Office)
2006-01-18	2007-06-04	Address	282 A HIEGIE LANE #279, WEST ISLIP, NY, 11795, USA (Type of address: Service of Process)
2003-05-29	2006-01-18	Address	279 282 A HIGBIE LANE, WEST ISLIP, NY, 11795, USA (Type of address: Service of Process)

Filing Number	Date Filed	Type	Effective Date
DP-2148607	2016-06-29	DISSOLUTION BY PROCLAMATION	2016-06-29
070604002538	2007-06-04	BIENNIAL STATEMENT	2007-05-01
060118002156	2006-01-18	BIENNIAL STATEMENT	2005-05-01
030529000162	2003-05-29	CERTIFICATE OF INCORPORATION	2003-05-29

Loan Number

Loan Funded Date

SBA Origination Office Code

Loan Delivery Method

Borrower Street Address

4076957307

2020-04-29

0235

PPP

197 Broadway, Amityville, NY, 11701

Loan Status Date	2021-03-19
Loan Status	Paid in Full
Loan Maturity in Months	24
SBA Guaranty Percentage	100
Loan Approval Amount (at origination)	51000
Loan Approval Amount (current)	51000
Undisbursed Amount	0
Franchise Name	-
Lender Location ID	28811
Servicing Lender Name	Capital One, National Association
Servicing Lender Address	1680 Capital One Dr, MCLEAN, VA, 22102-3407
Rural or Urban Indicator	U
Hubzone	N
LMI	Y
Business Age Description	Existing or more than 2 years old
Project Address	Amityville, SUFFOLK, NY, 11701-0001
Project Congressional District	NY-02
Number of Employees	5
NAICS code	621111
Borrower Race	Unanswered
Borrower Ethnicity	Unknown/NotStated
Business Type	Corporation
Originating Lender ID	28811
Originating Lender Name	Capital One, National Association
Originating Lender Address	MCLEAN, VA
Gender	Unanswered
Veteran	Unanswered
Forgiveness Amount	51398.08
Forgiveness Paid Date	2021-02-17

Date of last update: 30 Mar 2025