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BEHAVIORAL HEALTH MEDICAL PRACTICE, P.C.

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Company Details

Name: BEHAVIORAL HEALTH MEDICAL PRACTICE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 22 Sep 2006 (19 years ago)
Entity Number: 3415723
ZIP code: 11772
County: Suffolk
Place of Formation: New York
Address: 240 PATCHOGUE YAPHANK RD, STE 211, PATCHOGUE, NY, United States, 11772
Principal Address: 110 FIG DRIVE, DIX HILLS, NY, United States, 11746

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Agent

Name Role Address
MOATAZ YOUSEF HAGGAG Agent 200 EAST MAIN STREET, PATCHOGUE, NY, 11772

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 240 PATCHOGUE YAPHANK RD, STE 211, PATCHOGUE, NY, United States, 11772

Chief Executive Officer

Name Role Address
MOATAZ YOUSEF HAGGAG Chief Executive Officer 110 FIG DRIVE, DIX HILLS, NY, United States, 11746

National Provider Identifier

NPI Number:
1033232467
Certification Date:
2021-08-20

Authorized Person:

Name:
DR. MOATAZ YOUSEF HAGGAG
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
174400000X - Specialist
Is Primary:
Yes

Contacts:

Fax:
6312069299

Form 5500 Series

Employer Identification Number (EIN):
061803736
Plan Year:
2023
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
0
Sponsors Telephone Number:

History

Start date End date Type Value
2010-09-09 2012-10-03 Address 240 PATCHOGUE YAPHANK RD, STE 211, PATCHOGUE, NY, 11772, USA (Type of address: Service of Process)
2006-09-22 2010-09-09 Address 200 EAST MAIN STREET, PATCHOGUE, NY, 11772, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
121003002065 2012-10-03 BIENNIAL STATEMENT 2012-09-01
100909002727 2010-09-09 BIENNIAL STATEMENT 2010-09-01
080915002692 2008-09-15 BIENNIAL STATEMENT 2008-09-01
061205000523 2006-12-05 CERTIFICATE OF AMENDMENT 2006-12-05
060922000035 2006-09-22 CERTIFICATE OF INCORPORATION 2006-09-22

USAspending Awards / Financial Assistance

Date:
2020-06-03
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:
37500.00
Total Face Value Of Loan:
37500.00

Paycheck Protection Program

Date Approved:
2020-06-03
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
37500
Current Approval Amount:
37500
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
37907.31

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State