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BRENTWOOD PEDIATRIC AND ADOLESCENT ASSOCIATES, P.C.

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Company Details

Name: BRENTWOOD PEDIATRIC AND ADOLESCENT ASSOCIATES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 23 Sep 2003 (22 years ago)
Entity Number: 2957000
ZIP code: 11717
County: Suffolk
Place of Formation: New York
Principal Address: 27 WICKS RD, BRENTWOOD, NY, United States, 11717
Address: 27 WICKS ROAD, BRENTWOOD, NY, United States, 11717

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
JUAN C ESPINOZA MD Chief Executive Officer 27 WICKS ROAD, BRENTWOOD, NY, United States, 11717

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 27 WICKS ROAD, BRENTWOOD, NY, United States, 11717

National Provider Identifier

NPI Number:
1578753075

Authorized Person:

Name:
DR. JUAN C ESPINOZA
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
2080A0000X - Pediatric Adolescent Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
6314353288

Form 5500 Series

Employer Identification Number (EIN):
200257463
Plan Year:
2024
Number Of Participants:
47
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
43
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
42
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
39
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
41
Sponsors Telephone Number:

History

Start date End date Type Value
2003-09-23 2005-04-14 Address 27 WICKS ROAD, BRENTWOOD, NY, 11717, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
110207002980 2011-02-07 BIENNIAL STATEMENT 2009-09-01
060110003214 2006-01-10 BIENNIAL STATEMENT 2005-09-01
050414000725 2005-04-14 CERTIFICATE OF AMENDMENT 2005-04-14
030923000195 2003-09-23 CERTIFICATE OF INCORPORATION 2003-09-23

Paycheck Protection Program

Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
425000
Current Approval Amount:
425000
Race:
White
Ethnicity:
Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
430102.12

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Date of last update: 29 Mar 2025

Sources: New York Secretary of State