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CROSS PARK MEDICAL, PLLC

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Company Details

Name: CROSS PARK MEDICAL, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 25 Mar 2005 (20 years ago)
Entity Number: 3182466
ZIP code: 10024
County: New York
Place of Formation: New York
Address: 280 WEST 81ST ST., NEW YORK, NY, United States, 10024

DOS Process Agent

Name Role Address
CROSS PARK MEDICAL,PLLC DOS Process Agent 280 WEST 81ST ST., NEW YORK, NY, United States, 10024

National Provider Identifier

NPI Number:
1386832137

Authorized Person:

Name:
KATHERINE ANN HAWKINS
Role:
PARTNER OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207RG0300X - Geriatric Medicine (Internal Medicine) Physician
Is Primary:
No
Selected Taxonomy:
207RH0000X - Hematology (Internal Medicine) Physician
Is Primary:
No
Selected Taxonomy:
207RP1001X - Pulmonary Disease Physician
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
2127246158

Form 5500 Series

Employer Identification Number (EIN):
760789200
Plan Year:
2023
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
7
Sponsors Telephone Number:

History

Start date End date Type Value
2005-03-25 2017-03-29 Address 200 WEST 86TH STREET STE 1-I, NEW YORK, NY, 10024, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
220411003030 2022-04-11 BIENNIAL STATEMENT 2021-03-01
170329000060 2017-03-29 CERTIFICATE OF CHANGE 2017-03-29
110331002632 2011-03-31 BIENNIAL STATEMENT 2011-03-01
090302003574 2009-03-02 BIENNIAL STATEMENT 2009-03-01
081120000065 2008-11-20 CERTIFICATE OF PUBLICATION 2008-11-20

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Date of last update: 29 Mar 2025

Sources: New York Secretary of State