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LONG ISLAND NEUROPSYCHOLOGY, P.C.

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Company Details

Name: LONG ISLAND NEUROPSYCHOLOGY, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 21 Dec 2006 (19 years ago)
Entity Number: 3452585
ZIP code: 11779
County: Suffolk
Place of Formation: New York
Address: 290 HAWKINS AVE STE B, LAKE RONKONKOMA, NY, United States, 11779

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 290 HAWKINS AVE STE B, LAKE RONKONKOMA, NY, United States, 11779

Chief Executive Officer

Name Role Address
SHANE BUSH Chief Executive Officer 290 HAWKINS AVE STE B, LAKE RONKONKOMA, NY, United States, 11779

National Provider Identifier

NPI Number:
1356467419

Authorized Person:

Name:
DR. SHANE S. BUSH
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
103G00000X - Clinical Neuropsychologist
Is Primary:
No
Selected Taxonomy:
103T00000X - Psychologist
Is Primary:
No
Selected Taxonomy:
103TC0700X - Clinical Psychologist
Is Primary:
No
Selected Taxonomy:
103TF0200X - Forensic Psychologist
Is Primary:
No
Selected Taxonomy:
103TR0400X - Rehabilitation Psychologist
Is Primary:
No

Contacts:

History

Start date End date Type Value
2006-12-21 2014-07-31 Address 596 SMITHTOWN BYPASS, SUITE 304, SMITHTOWN, NY, 11787, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
140731002126 2014-07-31 BIENNIAL STATEMENT 2012-12-01
061221000824 2006-12-21 CERTIFICATE OF INCORPORATION 2006-12-21

Paycheck Protection Program

Jobs Reported:
1
Initial Approval Amount:
$15,000
Date Approved:
2020-05-20
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$15,000
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$15,137.92
Servicing Lender:
TD Bank, National Association
Use of Proceeds:
Payroll: $15,000

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State