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SUNRISE FAMILY MEDICAL, P.C.

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Company Details

Name: SUNRISE FAMILY MEDICAL, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 17 Feb 2005 (20 years ago)
Entity Number: 3165846
ZIP code: 11704
County: Suffolk
Place of Formation: New York
Address: 762 ELMWOOD ROAD, WEST BABYLON, NY, United States, 11704

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
PATRICK BARRETT DOS Process Agent 762 ELMWOOD ROAD, WEST BABYLON, NY, United States, 11704

National Provider Identifier

NPI Number:
1932379914

Authorized Person:

Name:
LINDA PURCELL
Role:
OFFICE ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
6314729777

Form 5500 Series

Employer Identification Number (EIN):
202363808
Plan Year:
2012
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
19
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
19
Sponsors Telephone Number:

Filings

Filing Number Date Filed Type Effective Date
050217000601 2005-02-17 CERTIFICATE OF INCORPORATION 2005-02-17

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Date of last update: 29 Mar 2025

Sources: New York Secretary of State