Search icon

LAWRENCE BLUM, M.D., P.C.

Company Details

Name: LAWRENCE BLUM, M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 25 Sep 2012 (13 years ago)
Entity Number: 4300057
ZIP code: 11415
County: New York
Place of Formation: New York
Address: 80-02 Kew Gardens Rd, Ste 600, Kew Gardens, NY, United States, 11415
Principal Address: 116-24 Grosvenor Lane, Unit CU3, Kew Gardens, NY, United States, 11415

Contact Details

Phone +1 212-241-6500

Phone +1 212-434-2000

Phone +1 718-847-2020

Phone +1 212-838-9200

Phone +1 718-728-3400

Phone +1 718-670-5607

Phone +1 212-751-8374

Phone +1 718-849-8700

Phone +1 718-206-6000

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 80-02 Kew Gardens Rd, Ste 600, Kew Gardens, NY, United States, 11415

Chief Executive Officer

Name Role Address
LAWRENCE BLUM Chief Executive Officer 116-24 GROSVENOR LANE, UNIT CU3, KEW GARDENS, NY, United States, 11415

National Provider Identifier

NPI Number:
1417381880

Authorized Person:

Name:
MS. DEBORAH VARELA
Role:
BILLING MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207W00000X - Ophthalmology Physician
Is Primary:
Yes

Contacts:

Fax:
2127518374

Form 5500 Series

Employer Identification Number (EIN):
461075104
Plan Year:
2023
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
14
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
14
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
12
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
12
Sponsors Telephone Number:

History

Start date End date Type Value
2012-09-25 2023-04-24 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2012-09-25 2023-04-24 Address 572 PARK AVE., NEW YORK, NY, 10021, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
230424000907 2023-04-24 BIENNIAL STATEMENT 2022-09-01
120925000370 2012-09-25 CERTIFICATE OF INCORPORATION 2012-09-25

Date of last update: 26 Mar 2025

Sources: New York Secretary of State