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UPSTATE PAIN MEDICINE, P.C.

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Company Details

Name: UPSTATE PAIN MEDICINE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 16 Feb 2005 (20 years ago)
Entity Number: 3165031
ZIP code: 13069
County: Oswego
Place of Formation: New York
Address: 59 S FIRST ST, FULTON, NY, United States, 13069

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 59 S FIRST ST, FULTON, NY, United States, 13069

Chief Executive Officer

Name Role Address
MAHESA R KUTHURU Chief Executive Officer 59 S FIRST ST, FULTON, NY, United States, 13069

National Provider Identifier

NPI Number:
1255498424

Authorized Person:

Name:
TARA LYNN LEE
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
174400000X - Specialist
Is Primary:
Yes

Contacts:

Fax:
3155931495

Form 5500 Series

Employer Identification Number (EIN):
202365121
Plan Year:
2009
Number Of Participants:
5
Sponsors Telephone Number:

History

Start date End date Type Value
2005-02-16 2007-03-12 Address 59 SOUTH FIRST STREET, FULTON, NY, 13069, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
090209002444 2009-02-09 BIENNIAL STATEMENT 2009-02-01
070312002633 2007-03-12 BIENNIAL STATEMENT 2007-02-01
050216000326 2005-02-16 CERTIFICATE OF INCORPORATION 2005-02-16

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Date of last update: 29 Mar 2025

Sources: New York Secretary of State