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STATEN ISLAND PHYSICIAN PRACTICE, P.C.

STATEN ISLAND PHYSICIAN PRACTICE, P.C.

Company Details

Name:	STATEN ISLAND PHYSICIAN PRACTICE, P.C.
Jurisdiction:	New York
Legal type:	DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status:	Inactive
Date of registration:	06 Apr 2006 (19 years ago)
Date of dissolution:	31 Dec 2016
Entity Number:	3345425
ZIP code:	10041
County:	New York
Place of Formation:	New York
Address:	55 WATER STREET, NEW YORK, NY, United States, 10041
Principal Address:	55 WATER ST, NEW YORK, NY, United States, 10041

Shares Details

Shares issued 1000

Share Par Value 1

Type PAR VALUE

Chief Executive Officer

Name	Role	Address
NAVARRA RODRIGUEZ, M.D.	Chief Executive Officer	55 WATER ST, NEW YORK, NY, United States, 10041

DOS Process Agent

Name	Role	Address
STATEN ISLAND PHYSICIAN PRACTICE	DOS Process Agent	55 WATER STREET, NEW YORK, NY, United States, 10041

Form 5500 Series

Employer Identification Number (EIN):

204659577

Plan Year:

2010

Number Of Participants:

89

Sponsors Telephone Number:

7188163850

File:

History

Start date	End date	Type	Value
2015-01-12	2016-09-23	Address	55 WATER ST, NEW YORK, NY, 10041, USA (Type of address: Chief Executive Officer)
2014-07-07	2015-01-12	Address	441 NINTH AVENUE, 8TH FLOOR, NEW YORK, NY, 10001, USA (Type of address: Chief Executive Officer)
2014-07-07	2016-09-23	Address	440 9TH AVENUE, 9TH FLOOR, NEW YORK, NY, 10001, USA (Type of address: Service of Process)
2014-07-07	2015-01-12	Address	441 NINTH AVENUE, 8TH FLOOR, NEW YORK, NY, 10001, USA (Type of address: Principal Executive Office)
2013-04-01	2014-07-07	Address	C/O EMBLEMHEALTH, 441 NINTH AVENUE, NEW YORK, NY, 10001, USA (Type of address: Service of Process)

Filings

Filing Number	Date Filed	Type	Effective Date
161216000136	2016-12-16	CERTIFICATE OF MERGER	2016-12-31
160923006063	2016-09-23	BIENNIAL STATEMENT	2016-04-01
150112002024	2015-01-12	AMENDMENT TO BIENNIAL STATEMENT	2014-04-01
140707002064	2014-07-07	BIENNIAL STATEMENT	2014-04-01
130401000286	2013-04-01	CERTIFICATE OF AMENDMENT	2013-04-01

Date of last update: 28 Mar 2025

Sources: New York Secretary of State