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LONG ISLAND KIDNEY CARE, P.C.

LONG ISLAND KIDNEY CARE, P.C.

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Company Details

Name:	LONG ISLAND KIDNEY CARE, P.C.
Jurisdiction:	New York
Legal type:	DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status:	Active
Date of registration:	27 Jul 2007 (18 years ago)
Entity Number:	3548988
ZIP code:	11545
County:	Suffolk
Place of Formation:	New York
Address:	1719 CEDAR SWAMP ROAD, GLENHEAD, NY, United States, 11545
Principal Address:	3 BEECH TREE LANE, GLEN HEAD, NY, United States, 11545

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name	Role	Address
MOHSEN PAHLAVAN	Chief Executive Officer	3 BEECH TREE LANE, GLEN HEAD, NY, United States, 11545

DOS Process Agent

Name	Role	Address
THE CORPORATION	DOS Process Agent	1719 CEDAR SWAMP ROAD, GLENHEAD, NY, United States, 11545

National Provider Identifier

NPI Number:

1063190064

Certification Date:

2023-07-10

Link:

View on NPI website

Authorized Person:

Name:

DR. MOHSEN PAHLAVAN

Role:

OWNER

Phone:

5162619988

Taxonomy:

Selected Taxonomy:

207RN0300X - Nephrology Physician

Is Primary:

Yes

Contacts:

Phone:

+1 516-261-9988

Fax:

5166120071

Form 5500 Series

Employer Identification Number (EIN):

260315154

Plan Year:

2018

Number Of Participants:

2

Sponsors Telephone Number:

5166211689

File:

Plan Year:

2018

Number Of Participants:

2

Sponsors Telephone Number:

5166211689

File:

Plan Year:

2017

Number Of Participants:

2

Sponsors Telephone Number:

5166211689

File:

Plan Year:

2017

Number Of Participants:

2

Sponsors Telephone Number:

5166211689

File:

Plan Year:

2016

Number Of Participants:

2

Sponsors Telephone Number:

5166211689

File:

Filings

Filing Number	Date Filed	Type	Effective Date
110808002240	2011-08-08	BIENNIAL STATEMENT	2011-07-01
070727000694	2007-07-27	CERTIFICATE OF INCORPORATION	2007-07-27

Paycheck Protection Program

Jobs Reported:

6

Initial Approval Amount:

$57,450

Date Approved:

2021-03-26

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$57,450

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$57,987.8

Servicing Lender:

TD Bank, National Association

Use of Proceeds:

Payroll: $57,445
Utilities: $1

Jobs Reported:

5

Initial Approval Amount:

$54,455

Date Approved:

2020-04-29

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$54,455

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$54,954.17

Servicing Lender:

TD Bank, National Association

Use of Proceeds:

Payroll: $54,455

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State