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EBENEZER ODOOM, M.D., P.C.

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Company Details

Name: EBENEZER ODOOM, M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 19 Dec 2012 (13 years ago)
Entity Number: 4335497
ZIP code: 11427
County: Queens
Place of Formation: New York
Address: 215-30 HILLSIDE AVE, QUEENS VILLAGE, NY, United States, 11427

Contact Details

Phone +1 718-670-1231

Phone +1 718-740-1701

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
EBENEZER ODOOM Chief Executive Officer 215-30 HILLSIDE AVE, QUEENS VILLAGE, NY, United States, 11427

DOS Process Agent

Name Role Address
DR. EBENEZER ODOOM DOS Process Agent 215-30 HILLSIDE AVE, QUEENS VILLAGE, NY, United States, 11427

National Provider Identifier

NPI Number:
1942642038

Authorized Person:

Name:
EBENEZER ODOOM
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
No
Selected Taxonomy:
207RG0300X - Geriatric Medicine (Internal Medicine) Physician
Is Primary:
Yes

Contacts:

Fax:
7187401901

Form 5500 Series

Employer Identification Number (EIN):
461674006
Plan Year:
2023
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
4
Sponsors Telephone Number:

History

Start date End date Type Value
2012-12-19 2015-02-24 Address 9204 SPRINGFIELD BLVD., QUEENS VILLAGE, NY, 11428, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
150224006270 2015-02-24 BIENNIAL STATEMENT 2014-12-01
121219001018 2012-12-19 CERTIFICATE OF INCORPORATION 2012-12-19

Paycheck Protection Program

Jobs Reported:
5
Initial Approval Amount:
$45,698.22
Date Approved:
2020-06-15
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$45,698.22
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$46,112.04
Servicing Lender:
Fundbox, Inc.
Use of Proceeds:
Payroll: $45,698.22

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State