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77TH ST-5TH AVE MEDICAL, P.C.

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Company Details

Name: 77TH ST-5TH AVE MEDICAL, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 18 Feb 2009 (16 years ago)
Date of dissolution: 11 Jun 2024
Entity Number: 3775941
ZIP code: 11209
County: Kings
Place of Formation: New York
Address: 452 77TH STREET, BROOKLYN, NY, United States, 11209

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
ELIOT ZIMBALIST Chief Executive Officer 452 77TH STREET, BROOKLYN, NY, United States, 11209

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 452 77TH STREET, BROOKLYN, NY, United States, 11209

National Provider Identifier

NPI Number:
1467692244
Certification Date:
2021-07-07

Authorized Person:

Name:
ELIOT H ZIMBALIST
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207L00000X - Anesthesiology Physician
Is Primary:
Yes

Contacts:

Fax:
7189215781

History

Start date End date Type Value
2011-02-18 2024-08-13 Address 452 77TH STREET, BROOKLYN, NY, 11209, USA (Type of address: Chief Executive Officer)
2009-02-18 2024-06-11 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2009-02-18 2024-08-13 Address 452 77TH STREET, BROOKLYN, NY, 11209, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240813003197 2024-06-11 CERTIFICATE OF DISSOLUTION-CANCELLATION 2024-06-11
130307002666 2013-03-07 BIENNIAL STATEMENT 2013-02-01
110218002167 2011-02-18 BIENNIAL STATEMENT 2011-02-01
090218000118 2009-02-18 CERTIFICATE OF INCORPORATION 2009-02-18

USAspending Awards / Financial Assistance

Date:
2020-04-13
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
3000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00

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Date of last update: 27 Mar 2025

Sources: New York Secretary of State