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BROOKHAVEN PHYSICIAN SERVICES, P.C.

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Company Details

Name: BROOKHAVEN PHYSICIAN SERVICES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 27 Jul 2007 (18 years ago)
Date of dissolution: 23 Aug 2024
Entity Number: 3548904
ZIP code: 11772
County: Suffolk
Place of Formation: New York
Address: 101 HOSPITAL ROAD, EAST PATCHOGUE, NY, United States, 11772
Principal Address: 101 HOSPITAL ROAD, EAST PATHCOGUE, NY, United States, 11772

Contact Details

Phone +1 631-227-6665

Phone +1 631-730-8542

Phone +1 631-654-0335

Phone +1 631-227-6660

Phone +1 631-286-3995

Phone +1 631-475-6900

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
WEHBEH A. WEHBEH, M.D. Chief Executive Officer 101 HOSPITAL ROAD, EAST PATCHOGUE, NY, United States, 11772

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 101 HOSPITAL ROAD, EAST PATCHOGUE, NY, United States, 11772

National Provider Identifier

NPI Number:
1083807572

Authorized Person:

Name:
TROY DICKINSON
Role:
AUTHORIZED OFFICIAL
Phone:

Taxonomy:

Selected Taxonomy:
208D00000X - General Practice Physician
Is Primary:
Yes

Contacts:

History

Start date End date Type Value
2024-08-26 2024-08-26 Address 101 HOSPITAL ROAD, EAST PATCHOGUE, NY, 11772, USA (Type of address: Chief Executive Officer)
2024-08-26 2024-08-26 Address 101 HOSPITAL ROAD, EAST PATCHOGUE, NY, 11772, 4897, USA (Type of address: Chief Executive Officer)
2024-08-23 2024-08-23 Address 101 HOSPITAL ROAD, EAST PATCHOGUE, NY, 11772, 4897, USA (Type of address: Chief Executive Officer)
2024-08-23 2024-08-26 Address 101 HOSPITAL ROAD, EAST PATCHOGUE, NY, 11772, USA (Type of address: Chief Executive Officer)
2024-08-23 2024-08-23 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
240826000251 2024-08-23 CERTIFICATE OF DISSOLUTION-CANCELLATION 2024-08-23
240823000616 2024-08-23 BIENNIAL STATEMENT 2024-08-23
191209060631 2019-12-09 BIENNIAL STATEMENT 2019-07-01
150708006337 2015-07-08 BIENNIAL STATEMENT 2015-07-01
121106002468 2012-11-06 BIENNIAL STATEMENT 2011-07-01

Paycheck Protection Program

Jobs Reported:
51
Initial Approval Amount:
$721,835
Date Approved:
2020-05-04
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$721,835
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$730,958.19
Servicing Lender:
TD Bank, National Association
Use of Proceeds:
Payroll: $721,835
Jobs Reported:
35
Initial Approval Amount:
$565,155
Date Approved:
2021-04-06
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$565,155
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$571,952.56
Servicing Lender:
TD Bank, National Association
Use of Proceeds:
Payroll: $565,152
Utilities: $1

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State