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CENTERPORT FAMILY MEDICINE, P.C.

Company Details

Name: CENTERPORT FAMILY MEDICINE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 12 Apr 2004 (21 years ago)
Date of dissolution: 05 Apr 2023
Entity Number: 3039397
ZIP code: 11743
County: Suffolk
Place of Formation: New York
Address: 210 EAST MAIN STREET, HUNTINGTON, NY, United States, 11743

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ISLAND MEDICINE, PLLC 401(K) PLAN 2021 261554297 2022-07-10 CENTERPORT FAMILY MEDICINE, P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 6317577500
Plan sponsor’s address 210 EAST MAIN STREET #1, HUNTINGTON, NY, 11743

Signature of

Role Plan administrator
Date 2022-07-10
Name of individual signing DR. PATRICK BURNS
ISLAND MEDICINE, PLLC 401(K) PLAN 2021 261554297 2022-07-18 CENTERPORT FAMILY MEDICINE, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 6317577500
Plan sponsor’s address 210 EAST MAIN STREET #1, HUNTINGTON, NY, 11743

Signature of

Role Plan administrator
Date 2022-07-18
Name of individual signing DR. PATRICK BURNS
ISLAND MEDICINE, PLLC 401(K) PLAN 2020 261554297 2021-07-19 CENTERPORT FAMILY MEDICINE, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 6317577500
Plan sponsor’s address 210 EAST MAIN STREET #1, HUNTINGTON, NY, 11743

Signature of

Role Plan administrator
Date 2021-07-19
Name of individual signing DR. PATRICK BURNS
ISLAND MEDICINE, PLLC 401(K) PLAN 2019 261554297 2020-05-06 CENTERPORT FAMILY MEDICINE, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 6317577500
Plan sponsor’s address 210 EAST MAIN STREET #1, HUNTINGTON, NY, 11743

Signature of

Role Plan administrator
Date 2020-05-06
Name of individual signing DR. PATRICK BURNS
ISLAND MEDICINE, PLLC 401(K) PLAN 2018 261554297 2019-05-01 CENTERPORT FAMILY MEDICINE, P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 6317577500
Plan sponsor’s address 210 EAST MAIN STREET #1, HUNTINGTON, NY, 11743

Signature of

Role Plan administrator
Date 2019-05-01
Name of individual signing DR. PATRICK BURNS

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 210 EAST MAIN STREET, HUNTINGTON, NY, United States, 11743

Chief Executive Officer

Name Role Address
PATRICK B BURNS Chief Executive Officer 210 EAST MAIN STREET, HUNTINGTON, NY, United States, 11743

History

Start date End date Type Value
2010-04-30 2023-07-17 Address 210 EAST MAIN STREET, HUNTINGTON, NY, 11743, USA (Type of address: Chief Executive Officer)
2010-04-30 2023-07-17 Address 210 EAST MAIN STREET, HUNTINGTON, NY, 11743, USA (Type of address: Service of Process)
2006-04-17 2010-04-30 Address 2 SILLS CT, CENTERPORT, NY, 11721, USA (Type of address: Principal Executive Office)
2006-04-17 2010-04-30 Address 2 SILLS CT, CENTERPORT, NY, 11721, USA (Type of address: Chief Executive Officer)
2006-04-17 2010-04-30 Address 2 SILLS CT, CENTERPORT, NY, 11721, USA (Type of address: Service of Process)
2004-04-12 2023-04-05 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2004-04-12 2006-04-17 Address 247 ASHAROKEN AVENUE, NORTHPORT, NY, 11768, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
230717002796 2023-04-05 CERTIFICATE OF DISSOLUTION-CANCELLATION 2023-04-05
200401060396 2020-04-01 BIENNIAL STATEMENT 2020-04-01
140409006672 2014-04-09 BIENNIAL STATEMENT 2014-04-01
120628002222 2012-06-28 BIENNIAL STATEMENT 2012-04-01
100430002412 2010-04-30 BIENNIAL STATEMENT 2010-04-01
080408002809 2008-04-08 BIENNIAL STATEMENT 2008-04-01
060417003150 2006-04-17 BIENNIAL STATEMENT 2006-04-01
040412001111 2004-04-12 CERTIFICATE OF INCORPORATION 2004-04-12

Date of last update: 01 Jan 2025

Sources: New York Secretary of State