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FORM AND FUNCTION PHYSICAL THERAPY P.C.

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Company Details

Name: FORM AND FUNCTION PHYSICAL THERAPY P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 28 Jul 2011 (14 years ago)
Entity Number: 4123556
ZIP code: 11756
County: Nassau
Place of Formation: New York
Address: 387 GARDINERS AVE., LEVITTOWN, NY, United States, 11756
Principal Address: 387 GARDINERS AVE, LEVITTOWN, NY, United States, 11756

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 387 GARDINERS AVE., LEVITTOWN, NY, United States, 11756

Chief Executive Officer

Name Role Address
AMIR HANNA Chief Executive Officer 387 GARDINERS AVE, LEVITTOWN, NY, United States, 11756

National Provider Identifier

NPI Number:
1316332505

Authorized Person:

Name:
MR. AMIR MILAD HANNA
Role:
PHYSICAL THERAPIST
Phone:

Taxonomy:

Selected Taxonomy:
225100000X - Physical Therapist
Is Primary:
Yes

Contacts:

Fax:
5164659656

Filings

Filing Number Date Filed Type Effective Date
130726002048 2013-07-26 BIENNIAL STATEMENT 2013-07-01
110728000029 2011-07-28 CERTIFICATE OF INCORPORATION 2011-07-28

USAspending Awards / Financial Assistance

Date:
2020-05-02
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:
8092.00
Total Face Value Of Loan:
8092.00

Paycheck Protection Program

Jobs Reported:
1
Initial Approval Amount:
$8,092
Date Approved:
2020-05-02
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$8,092
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Non-Veteran
Forgiveness Amount:
$8,208.09
Servicing Lender:
JPMorgan Chase Bank, National Association
Use of Proceeds:
Payroll: $7,200
Utilities: $392
Healthcare: $500

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State