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DR. FAZELI & DR. BROUMAND, LLC

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Company Details

Name: DR. FAZELI & DR. BROUMAND, LLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 29 Jun 2006 (19 years ago)
Entity Number: 3382879
ZIP code: 13066
County: Onondaga
Place of Formation: New York
Address: 4110 MEDICAL CENTER DR, FAYETTEVILLE, NY, United States, 13066

DOS Process Agent

Name Role Address
DR. FAZELI & DR. BROUMAND, LLC DOS Process Agent 4110 MEDICAL CENTER DR, FAYETTEVILLE, NY, United States, 13066

National Provider Identifier

NPI Number:
1336235639
Certification Date:
2024-03-07

Authorized Person:

Name:
DR. AMIN FAZELI
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
Yes

Contacts:

Fax:
5856630052
Fax:
3156630052

Form 5500 Series

Employer Identification Number (EIN):
300382092
Plan Year:
2023
Number Of Participants:
42
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
56
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
42
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
60
Sponsors Telephone Number:

History

Start date End date Type Value
2015-12-02 2024-11-21 Address 4110 MEDICAL CENTER DR, FAYETTEVILLE, NY, 13066, USA (Type of address: Service of Process)
2010-07-07 2015-12-02 Address 4110 MEDICAL CENTER DR, FAYETTEVILLE, NY, 13066, USA (Type of address: Service of Process)
2008-06-09 2010-07-07 Address 4110 MEDICAL CENTER DR, FAYETTEVILLE, NY, 13066, USA (Type of address: Service of Process)
2006-06-29 2008-06-09 Address 100 WHITE SPRUCE BLVD, ROCHESTER, NY, 14623, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
241121002314 2024-11-21 BIENNIAL STATEMENT 2024-11-21
200604060158 2020-06-04 BIENNIAL STATEMENT 2020-06-01
180607006487 2018-06-07 BIENNIAL STATEMENT 2018-06-01
160606007403 2016-06-06 BIENNIAL STATEMENT 2016-06-01
151202007009 2015-12-02 BIENNIAL STATEMENT 2014-06-01

USAspending Awards / Financial Assistance

Date:
2021-02-01
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
470335.00
Total Face Value Of Loan:
470335.00

Paycheck Protection Program

Date Approved:
2021-01-31
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
470335
Current Approval Amount:
470335
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
474252.31

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State