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KENNETH B. CHAPMAN, M.D. PLLC

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Company Details

Name: KENNETH B. CHAPMAN, M.D. PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 12 Jul 2006 (19 years ago)
Entity Number: 3387576
ZIP code: 10314
County: Richmond
Place of Formation: New York
Address: 1534 VICTORY BOULEVARD, STATEN ISLAND, NY, United States, 10314

Contact Details

Phone +1 212-724-7246

Phone +1 212-724-7245

Phone +1 718-667-3577

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 1534 VICTORY BOULEVARD, STATEN ISLAND, NY, United States, 10314

National Provider Identifier

NPI Number:
1811915416
Certification Date:
2020-07-08

Authorized Person:

Name:
KENNETH BRADLEY CHAPMAN
Role:
CHAIRMAN
Phone:

Taxonomy:

Selected Taxonomy:
207LP2900X - Pain Medicine (Anesthesiology) Physician
Is Primary:
No
Selected Taxonomy:
208VP0014X - Interventional Pain Medicine Physician
Is Primary:
No
Selected Taxonomy:
208VP0000X - Pain Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
7183517151

Form 5500 Series

Employer Identification Number (EIN):
205195374
Plan Year:
2020
Number Of Participants:
23
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
44
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
44
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
53
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
56
Sponsors Telephone Number:

History

Start date End date Type Value
2006-07-12 2011-02-28 Address 8 FORT HILL PARK, STATEN ISLAND, NY, 10301, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
200728060332 2020-07-28 BIENNIAL STATEMENT 2020-07-01
180703007366 2018-07-03 BIENNIAL STATEMENT 2018-07-01
140805006434 2014-08-05 BIENNIAL STATEMENT 2014-07-01
120710006462 2012-07-10 BIENNIAL STATEMENT 2012-07-01
110228000835 2011-02-28 CERTIFICATE OF CHANGE 2011-02-28

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State