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SI MEDICAL PRACTICE ASSOCIATE P.C.

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Company Details

Name: SI MEDICAL PRACTICE ASSOCIATE P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 08 Jun 2005 (20 years ago)
Entity Number: 3215991
ZIP code: 10305
County: Richmond
Place of Formation: New York
Address: 271 MASON AVE, STATEN ISLAND, NY, United States, 10305
Principal Address: 558 MAIN STREET, STATEN ISLAND, NY, United States, 10307

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
AZHER U SIDDIQI MD Chief Executive Officer 271 MASON AVENUE, STATEN ISLAND, NY, United States, 10305

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 271 MASON AVE, STATEN ISLAND, NY, United States, 10305

National Provider Identifier

NPI Number:
1265505036

Authorized Person:

Name:
DR. AZHER SIDDIQI
Role:
OWNER PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207QS0010X - Sports Medicine (Family Medicine) Physician
Is Primary:
Yes

Contacts:

Fax:
7186682523

History

Start date End date Type Value
2013-10-25 2014-01-07 Name SI MEDICAL PRACTICE ASSOCIATES P.C.
2009-08-12 2011-07-29 Address 345 SEAVIEW AVE, STATEN ISLAND, NY, 10305, USA (Type of address: Chief Executive Officer)
2009-06-17 2009-08-12 Address 271 MASON AVE, STATEN ISLAND, NY, 10305, USA (Type of address: Chief Executive Officer)
2007-08-07 2009-06-17 Address 345 SEAVIEW AVENUE, STATEN ISLAND, NY, 10305, USA (Type of address: Chief Executive Officer)
2007-08-07 2009-08-12 Address 230 RED HILL RD, MIDDLETOWN, NJ, 07748, USA (Type of address: Principal Executive Office)

Filings

Filing Number Date Filed Type Effective Date
140107000675 2014-01-07 CERTIFICATE OF AMENDMENT 2014-01-07
131025000518 2013-10-25 CERTIFICATE OF AMENDMENT 2013-10-25
110729002688 2011-07-29 BIENNIAL STATEMENT 2011-06-01
090812002135 2009-08-12 AMENDMENT TO BIENNIAL STATEMENT 2009-06-01
090617002323 2009-06-17 BIENNIAL STATEMENT 2009-06-01

Paycheck Protection Program

Jobs Reported:
7
Initial Approval Amount:
$56,150
Date Approved:
2021-03-20
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$56,150
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$56,479.1
Servicing Lender:
Valley National Bank
Use of Proceeds:
Payroll: $56,145
Utilities: $1

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Date of last update: 29 Mar 2025

Sources: New York Secretary of State