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HOLBROOK INTERNAL MEDICINE, P.C.

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Company Details

Name: HOLBROOK INTERNAL MEDICINE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 01 Jul 2009 (16 years ago)
Entity Number: 3828801
ZIP code: 11741
County: Suffolk
Place of Formation: New York
Address: 900 MAIN STREET, HOLBROOK, NY, United States, 11741

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
DANIEL J LAIETA Chief Executive Officer 900 MAIN STREET, HOLBROOK, NY, United States, 11741

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 900 MAIN STREET, HOLBROOK, NY, United States, 11741

National Provider Identifier

NPI Number:
1972825420

Authorized Person:

Name:
DR. DANIEL JOSPEH LAIETA
Role:
PRESIDENT/CEO
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

History

Start date End date Type Value
2012-03-07 2025-06-11 Address 900 MAIN STREET, HOLBROOK, NY, 11741, USA (Type of address: Chief Executive Officer)
2012-03-07 2025-06-11 Address 900 MAIN STREET, HOLBROOK, NY, 11741, USA (Type of address: Service of Process)
2009-07-01 2012-03-07 Address 1 LITTLE LEAF COURT, WADING RIVER, NY, 11792, USA (Type of address: Service of Process)
2009-07-01 2025-03-05 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
250611000496 2025-03-05 CERTIFICATE OF DISSOLUTION-CANCELLATION 2025-03-05
130802002093 2013-08-02 BIENNIAL STATEMENT 2013-07-01
120307002284 2012-03-07 BIENNIAL STATEMENT 2011-07-01
090701000463 2009-07-01 CERTIFICATE OF INCORPORATION 2009-07-01

USAspending Awards / Financial Assistance

Date:
2020-04-28
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:
47300.00
Total Face Value Of Loan:
47300.00

Paycheck Protection Program

Jobs Reported:
7
Initial Approval Amount:
$47,300
Date Approved:
2020-04-28
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$47,300
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$47,618.79
Servicing Lender:
Loan Source Incorporated
Use of Proceeds:
Payroll: $47,300

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Date of last update: 27 Mar 2025

Sources: New York Secretary of State