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ISLAND MEDICAL GROUP, P.C.

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Company Details

Name: ISLAND MEDICAL GROUP, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 07 Jun 1976 (49 years ago)
Date of dissolution: 24 Jun 1981
Entity Number: 401725
ZIP code: 11791
County: Nassau
Place of Formation: New York
Address: 175 JERICHO TPKE., SYOSSET, NY, United States, 11791

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
ISLAND MEDICAL GROUP, P.C. DOS Process Agent 175 JERICHO TPKE., SYOSSET, NY, United States, 11791

National Provider Identifier

NPI Number:
1285748749

Authorized Person:

Name:
MRS. SUSAN BRENNER-SMITH
Role:
BILLING MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207RC0000X - Cardiovascular Disease Physician
Is Primary:
No
Selected Taxonomy:
207RE0101X - Endocrinology, Diabetes & Metabolism Physician
Is Primary:
No
Selected Taxonomy:
207RG0100X - Gastroenterology Physician
Is Primary:
No
Selected Taxonomy:
207RR0500X - Rheumatology Physician
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
5167317052

Form 5500 Series

Employer Identification Number (EIN):
112343270
Plan Year:
2012
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
8
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
29
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
48
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
56
Sponsors Telephone Number:

Filings

Filing Number Date Filed Type Effective Date
20080225040 2008-02-25 ASSUMED NAME LLC INITIAL FILING 2008-02-25
DP-23892 1981-06-24 DISSOLUTION BY PROCLAMATION 1981-06-24
A319903-9 1976-06-07 CERTIFICATE OF INCORPORATION 1976-06-07

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Date of last update: 18 Mar 2025

Sources: New York Secretary of State