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ASSOCIATED GASTROENTEROLOGISTS OF CENTRAL NEW YORK, P.C.

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Company Details

Name: ASSOCIATED GASTROENTEROLOGISTS OF CENTRAL NEW YORK, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 22 Jun 1976 (49 years ago)
Entity Number: 402965
ZIP code: 13031
County: Onondaga
Place of Formation: New York
Address: 260 Township Blvd, SUITE 20, Camillus, NY, United States, 13031
Principal Address: 260 TOWNSHIP BLVD, SUITE 20, CAMILLUS, NY, United States, 13031

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
ASSOCIATED GASTROENTEROLOGISTS OF CENTRAL NEW YORK, P.C. DOS Process Agent 260 Township Blvd, SUITE 20, Camillus, NY, United States, 13031

Chief Executive Officer

Name Role Address
SCOTT EDISON Chief Executive Officer 260 TOWNSHIP BLVD, SUITE 20, CAMILLUS, NY, United States, 13031

National Provider Identifier

NPI Number:
1013938174

Authorized Person:

Name:
CAROL GALLUP
Role:
CREDENTIALING COORDINATOR
Phone:

Taxonomy:

Selected Taxonomy:
207RG0100X - Gastroenterology Physician
Is Primary:
Yes

Contacts:

Fax:
3157080194
Fax:
3154883284

Form 5500 Series

Employer Identification Number (EIN):
161071730
Plan Year:
2023
Number Of Participants:
76
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
100
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
68
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
82
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
61
Sponsors Telephone Number:

History

Start date End date Type Value
2024-06-03 2024-06-03 Address 260 TOWNSHIP BLVD, SUITE 20, CAMILLUS, NY, 13031, 1674, USA (Type of address: Chief Executive Officer)
2024-06-03 2024-06-03 Address 260 TOWNSHIP BLVD, SUITE 20, CAMILLUS, NY, 13031, USA (Type of address: Chief Executive Officer)
2018-06-12 2024-06-03 Address 260 TOWNSHIP BLVD, SUITE 20, CAMILLUS, NY, 13031, 1674, USA (Type of address: Chief Executive Officer)
2016-06-01 2018-06-12 Address 260 TOWNSHIP BLVD, SUITE 20, CAMILLUS, NY, 13031, 1674, USA (Type of address: Chief Executive Officer)
2016-06-01 2024-06-03 Address 260 TOWNSHIP BLVD, SUITE 20, CAMILLUS, NY, 13031, 1674, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240603002227 2024-06-03 BIENNIAL STATEMENT 2024-06-03
220906002586 2022-09-06 BIENNIAL STATEMENT 2022-06-01
200608060917 2020-06-08 BIENNIAL STATEMENT 2020-06-01
180612006414 2018-06-12 BIENNIAL STATEMENT 2018-06-01
160601006925 2016-06-01 BIENNIAL STATEMENT 2016-06-01

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Date of last update: 18 Mar 2025

Sources: New York Secretary of State