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EMPIRE STATE PAIN & NEURO, P.C.

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Company Details

Name: EMPIRE STATE PAIN & NEURO, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 07 Feb 2011 (14 years ago)
Date of dissolution: 31 Aug 2016
Entity Number: 4051746
ZIP code: 11375
County: Suffolk
Place of Formation: New York
Address: P.O. BOX 750537, FOREST HILLS, NY, United States, 11375

Shares Details

Shares issued 100

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
EMPIRE STATE PAIN & NEURO, P.C. DOS Process Agent P.O. BOX 750537, FOREST HILLS, NY, United States, 11375

Chief Executive Officer

Name Role Address
SAMUEL THEAGENE Chief Executive Officer P.O BOX 750537, FOREST HILLS, NY, United States, 11375

National Provider Identifier

NPI Number:
1558634477

Authorized Person:

Name:
DR. SAMUEL MICHAEL THEAGENE
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
Yes

Contacts:

Fax:
6316541681

History

Start date End date Type Value
2013-03-04 2015-02-02 Address 2025 BRENTWOOD, BRENTWOOD, NY, 11717, USA (Type of address: Chief Executive Officer)
2013-03-04 2015-02-02 Address 2025 BRENTWOOD ROAD, BRENTWOOD, NY, 11717, USA (Type of address: Principal Executive Office)
2013-03-04 2015-02-02 Address 2025 BRENTWOOD ROAD, BRENTWOOD, NY, 11717, USA (Type of address: Service of Process)
2011-02-07 2013-03-04 Address 659 SUFFOLK AVE., BRENTWOOD, NY, 11717, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
DP-2191213 2016-08-31 DISSOLUTION BY PROCLAMATION 2016-08-31
150202006479 2015-02-02 BIENNIAL STATEMENT 2015-02-01
130304006075 2013-03-04 BIENNIAL STATEMENT 2013-02-01
110207000403 2011-02-07 CERTIFICATE OF INCORPORATION 2011-02-07

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Date of last update: 27 Mar 2025

Sources: New York Secretary of State