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STATEN ISLAND MEDICINE, P.C.

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Company Details

Name: STATEN ISLAND MEDICINE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 22 Jan 2009 (17 years ago)
Entity Number: 3766250
ZIP code: 10314
County: Richmond
Place of Formation: New York
Address: 1000 SOUTH AVENUE, SUITE 104, STATEN ISLAND, NY, United States, 10314
Principal Address: 682 FOREST AVE, STATEN ISLAND, NY, United States, 10310

Contact Details

Phone +1 718-818-1234

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
FRANK SCAFURI III Chief Executive Officer 682 FOREST AVE, STATEN ISLAND, NY, United States, 10310

DOS Process Agent

Name Role Address
STATEN ISLAND MEDICINE, P.C. DOS Process Agent 1000 SOUTH AVENUE, SUITE 104, STATEN ISLAND, NY, United States, 10314

National Provider Identifier

NPI Number:
1881829224

Authorized Person:

Name:
DR. FRANK SCAFURI III
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207RC0200X - Critical Care Medicine (Internal Medicine) Physician
Is Primary:
Yes

Contacts:

Fax:
7186989412

History

Start date End date Type Value
2009-01-22 2019-06-18 Address 682 FOREST AVENUE, STATEN ISLAND, NY, 10310, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
190618060303 2019-06-18 BIENNIAL STATEMENT 2019-01-01
170103007517 2017-01-03 BIENNIAL STATEMENT 2017-01-01
130117006051 2013-01-17 BIENNIAL STATEMENT 2013-01-01
110118002368 2011-01-18 BIENNIAL STATEMENT 2011-01-01
090902000678 2009-09-02 CERTIFICATE OF AMENDMENT 2009-09-02

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Date of last update: 27 Mar 2025

Sources: New York Secretary of State