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SISSELMAN MEDICAL GROUP, P.C.

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Company Details

Name: SISSELMAN MEDICAL GROUP, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 09 Nov 2007 (18 years ago)
Entity Number: 3591707
ZIP code: 11758
County: Nassau
Place of Formation: New York
Address: 627 Broadway, STE 1, MASSAPEQUA, NY, United States, 11758
Principal Address: 627 BROADWAY, STE 1, MASSAPEQUA, NY, United States, 11758

Contact Details

Phone +1 516-308-4040

Phone +1 631-670-6525

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
SISSELMAN MEDICAL GROUP, P.C. DOS Process Agent 627 Broadway, STE 1, MASSAPEQUA, NY, United States, 11758

Chief Executive Officer

Name Role Address
STEPHEN SISSELMAN Chief Executive Officer 627 BROADWAY, STE 1, MASSAPEQUA, NY, United States, 11758

National Provider Identifier

NPI Number:
1851572358
Certification Date:
2022-10-12

Authorized Person:

Name:
DR. STEPHEN SISSELMAN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
5168046386

History

Start date End date Type Value
2023-11-01 2023-11-01 Address 627 BROADWAY, STE 1, MASSAPEQUA, NY, 11758, USA (Type of address: Chief Executive Officer)
2023-09-25 2023-11-01 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2023-07-27 2023-09-25 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2022-12-15 2023-11-01 Address 627 BROADWAY, STE 1, MASSAPEQUA, NY, 11758, USA (Type of address: Chief Executive Officer)
2022-12-15 2022-12-15 Address 627 BROADWAY, STE 1, MASSAPEQUA, NY, 11758, USA (Type of address: Chief Executive Officer)

Filings

Filing Number Date Filed Type Effective Date
231101036067 2023-11-01 BIENNIAL STATEMENT 2023-11-01
221215002862 2022-04-01 CERTIFICATE OF CHANGE BY ENTITY 2022-04-01
220325002234 2022-03-25 BIENNIAL STATEMENT 2021-11-01
191101060080 2019-11-01 BIENNIAL STATEMENT 2019-11-01
171101006061 2017-11-01 BIENNIAL STATEMENT 2017-11-01

USAspending Awards / Financial Assistance

Date:
2021-01-27
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:
278730.00
Total Face Value Of Loan:
278730.00
Date:
2020-04-13
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:
246660.00
Total Face Value Of Loan:
246660.00

Paycheck Protection Program

Jobs Reported:
30
Initial Approval Amount:
$246,660
Date Approved:
2020-04-11
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$246,660
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$248,687.82
Servicing Lender:
JPMorgan Chase Bank, National Association
Use of Proceeds:
Payroll: $220,023
Utilities: $1,576
Mortgage Interest: $0
Rent: $20,366
Refinance EIDL: $0
Healthcare: $4695
Debt Interest: $0
Jobs Reported:
25
Initial Approval Amount:
$278,730
Date Approved:
2021-01-27
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$278,730
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$280,884.89
Servicing Lender:
JPMorgan Chase Bank, National Association
Use of Proceeds:
Payroll: $278,729

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State