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JERRY UDUEVBO, M.D., P.C.

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Company Details

Name: JERRY UDUEVBO, M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 22 Aug 2008 (17 years ago)
Entity Number: 3712494
ZIP code: 11226
County: Kings
Place of Formation: New York
Address: 2503 CHURCH AVE, BROOKLYN, NY, United States, 11226

Contact Details

Phone +1 718-427-6160

Shares Details

Shares issued 1

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
JERRY UDUEVBO, M.D. Chief Executive Officer 2503 CHURCH AVE, BROOKLYN, NY, United States, 11226

DOS Process Agent

Name Role Address
JERRY UDUEVBO, M.D., P.C. DOS Process Agent 2503 CHURCH AVE, BROOKLYN, NY, United States, 11226

National Provider Identifier

NPI Number:
1033436365

Authorized Person:

Name:
DR. JERRY UDUEVBO
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
263559347
Plan Year:
2023
Number Of Participants:
14
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
8
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
6
Sponsors Telephone Number:

History

Start date End date Type Value
2025-05-28 2025-05-28 Address 2503 CHURCH AVE, BROOKLYN, NY, 11226, USA (Type of address: Chief Executive Officer)
2023-07-13 2025-05-28 Shares Share type: NO PAR VALUE, Number of shares: 1, Par value: 0
2023-07-13 2025-05-28 Address 2503 CHURCH AVE, BROOKLYN, NY, 11226, USA (Type of address: Service of Process)
2023-07-13 2023-07-13 Address 2503 CHURCH AVE, BROOKLYN, NY, 11226, USA (Type of address: Chief Executive Officer)
2023-07-13 2025-05-28 Address 2503 CHURCH AVE, BROOKLYN, NY, 11226, USA (Type of address: Chief Executive Officer)

Filings

Filing Number Date Filed Type Effective Date
250528001053 2025-05-28 BIENNIAL STATEMENT 2025-05-28
230713001254 2023-07-13 BIENNIAL STATEMENT 2022-08-01
200803060077 2020-08-03 BIENNIAL STATEMENT 2020-08-01
140801006025 2014-08-01 BIENNIAL STATEMENT 2014-08-01
120824006001 2012-08-24 BIENNIAL STATEMENT 2012-08-01

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State