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UPPER WEST SIDE DERMATOLOGY P.C.

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Company Details

Name: UPPER WEST SIDE DERMATOLOGY P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 05 Apr 2007 (18 years ago)
Entity Number: 3499727
ZIP code: 10023
County: New York
Place of Formation: New York
Address: 115 CENTRAL PARK WEST, STE 1, NEW YORK, NY, United States, 10023

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
LISA TRAVIS MD Chief Executive Officer 115 CENTRAL PARK WEST, STE 1, NEW YORK, NY, United States, 10023

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 115 CENTRAL PARK WEST, STE 1, NEW YORK, NY, United States, 10023

National Provider Identifier

NPI Number:
1356504054

Authorized Person:

Name:
DR. LISA TRAVIS
Role:
OWNER
Phone:

Taxonomy:

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

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
208792077
Plan Year:
2023
Number Of Participants:
15
Sponsors Telephone Number:

History

Start date End date Type Value
2007-04-05 2014-07-09 Address 820 WEST END AVENUE APT 9E, NEW YORK, NY, 10025, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
140709002029 2014-07-09 BIENNIAL STATEMENT 2013-04-01
070405000348 2007-04-05 CERTIFICATE OF INCORPORATION 2007-04-05

Paycheck Protection Program

Jobs Reported:
11
Initial Approval Amount:
$170,370
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$170,370
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$172,406.02
Servicing Lender:
JPMorgan Chase Bank, National Association
Use of Proceeds:
Payroll: $150,370
Rent: $20,000

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State