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AMBOY MEDICAL PRACTICE, P.C.

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Company Details

Name: AMBOY MEDICAL PRACTICE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 27 Aug 2008 (17 years ago)
Entity Number: 3713988
ZIP code: 10310
County: Richmond
Place of Formation: New York
Address: ATT: BRIAN S. MOODY, ESQ., 355 BARD AVENUE, STATEN ISLAND, NY, United States, 10310
Principal Address: 355 BARD AVE, STATEN ISLAND, NY, United States, 10310

Contact Details

Phone +1 718-818-1058

Phone +1 718-720-2130

Phone +1 718-818-1501

Phone +1 718-818-6132

Phone +1 718-966-9226

Phone +1 718-818-5000

Phone +1 718-818-3327

Phone +1 718-761-4400

Phone +1 718-667-1200

Phone +1 718-351-6500

Phone +1 718-818-2420

Phone +1 917-873-0398

Phone +1 718-979-1794

Phone +1 718-370-7700

Phone +1 718-727-1366

Phone +1 718-370-2470

Phone +1 718-818-1161

Phone +1 718-948-8111

Phone +1 718-447-6545

Phone +1 718-720-6300

Phone +1 718-370-2100

Phone +1 718-876-2023

Phone +1 718-818-4000

Shares Details

Shares issued 200

Share Par Value 0.01

Type PAR VALUE

Chief Executive Officer

Name Role Address
ALEXANDER BEYLINSON, M.D. Chief Executive Officer 355 BARD AVE, STATEN ISLAND, NY, United States, 10310

DOS Process Agent

Name Role Address
AMBOY MEDICAL PRACTICE, P.C.,% RICHMOND UNIVERSITY MEDICAL CT DOS Process Agent ATT: BRIAN S. MOODY, ESQ., 355 BARD AVENUE, STATEN ISLAND, NY, United States, 10310

National Provider Identifier

NPI Number:
1104692672
Certification Date:
2023-11-27

Authorized Person:

Name:
JOAN MARIE NELSON
Role:
DIRECTOR NETWORK REVENUE CYCLE OPER
Phone:

Taxonomy:

Selected Taxonomy:
2085B0100X - Body Imaging Physician
Is Primary:
No
Selected Taxonomy:
2085D0003X - Diagnostic Neuroimaging (Radiology) Physician
Is Primary:
No
Selected Taxonomy:
2085N0904X - Nuclear Radiology Physician
Is Primary:
No
Selected Taxonomy:
2085P0229X - Pediatric Radiology Physician
Is Primary:
No
Selected Taxonomy:
2085R0001X - Radiation Oncology Physician
Is Primary:
No

Contacts:

Fax:
3478252117

History

Start date End date Type Value
2021-10-28 2024-12-24 Shares Share type: PAR VALUE, Number of shares: 200, Par value: 0.01
2010-11-01 2020-04-08 Address 355 BARD AVE, STATEN ISLAND, NY, 10310, USA (Type of address: Chief Executive Officer)
2008-08-27 2021-10-28 Shares Share type: PAR VALUE, Number of shares: 200, Par value: 0.01
2008-08-27 2020-04-08 Address ATT: CHIEF FINANCIAL OFFICER, 355 BARD AVENUE, STATEN ISLAND, NY, 10310, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
200408060385 2020-04-08 BIENNIAL STATEMENT 2018-08-01
120821002707 2012-08-21 BIENNIAL STATEMENT 2012-08-01
101101002286 2010-11-01 BIENNIAL STATEMENT 2010-08-01
080827000654 2008-08-27 CERTIFICATE OF INCORPORATION 2008-08-27

Tax Exempt

Employer Identification Number (EIN) :
26-3381883
In Care Of Name:
% DAVID MURRAY
Classification:
Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Ruling Date:
2014-08
Deductibility:
Type of organization and use of contribution: A Type I, Type II, or functionally integrated Type III supporting organization. Deductibility Limitation: 50% (60% for cash contributions)

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State