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NORTH SHORE-LIJ ANESTHESIOLOGY, P.C.

NORTH SHORE-LIJ ANESTHESIOLOGY, P.C.

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Company Details

Name:	NORTH SHORE-LIJ ANESTHESIOLOGY, P.C.
Jurisdiction:	New York
Legal type:	DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status:	Active
Date of registration:	20 Dec 2012 (13 years ago)
Entity Number:	4335702
ZIP code:	11042
County:	Nassau
Place of Formation:	New York
Address:	OFFICE OF LEGAL AFFAIRS, 2000 MARCUS AVENUE, NEW HYDE PARK, NY, United States, 11042
Principal Address:	C/O NORTHWELL HEALTH, INC., 2000 Marcus Avenue, New Hyde Park, NY, United States, 11042

Contact Details

Phone +1 212-434-2878

Phone +1 631-385-8677

Phone +1 212-838-9200

Phone +1 631-351-2645

Phone +1 631-968-3056

Phone +1 718-226-9292

Phone +1 914-666-8866

Shares Details

Shares issued 200

Share Par Value 1

Type PAR VALUE

DOS Process Agent

Name	Role	Address
ATTN: GENERAL COUNSEL	DOS Process Agent	OFFICE OF LEGAL AFFAIRS, 2000 MARCUS AVENUE, NEW HYDE PARK, NY, United States, 11042

Chief Executive Officer

Name	Role	Address
MITCHELL COHN, M.D.	Chief Executive Officer	C/O NORTHWELL HEALTH, INC., 2000 MARCUS AVENUE, NEW HYDE PARK, NY, United States, 11042

Links between entities

Type:

Headquarter of

Company Number:

1298734

State:

CONNECTICUT

CONNECTICUT profile:

NORTH SHORE-LIJ ANESTHESIOLOGY, P.C. (CT)

National Provider Identifier

NPI Number:

1417401266

Certification Date:

2022-07-08

Link:

View on NPI website

Authorized Person:

Name:

MRS. MICHELE L CUSACK

Role:

SENIOR VP & CFO

Phone:

5163216058

Taxonomy:

Selected Taxonomy:

207L00000X - Anesthesiology Physician

Is Primary:

Yes

Contacts:

Phone:

+1 914-666-8866

Fax:

9146666777

History

Start date	End date	Type	Value
2025-03-25	2025-04-18	Shares	Share type: PAR VALUE, Number of shares: 200, Par value: 1
2025-03-03	2025-03-25	Shares	Share type: PAR VALUE, Number of shares: 200, Par value: 1
2024-07-12	2025-03-03	Shares	Share type: PAR VALUE, Number of shares: 200, Par value: 1
2024-05-07	2024-07-12	Shares	Share type: PAR VALUE, Number of shares: 200, Par value: 1
2024-05-07	2024-05-07	Address	C/O NORTHWELL HEALTH, INC., 972 BRUSH HOLLOW ROAD, 5TH FL, WESTBURY, NY, 11590, 1745, USA (Type of address: Chief Executive Officer)

Filings

Filing Number	Date Filed	Type	Effective Date
240507003340	2024-05-07	BIENNIAL STATEMENT	2024-05-07
210720001054	2021-07-20	BIENNIAL STATEMENT	2021-07-20
180524000489	2018-05-24	CERTIFICATE OF CHANGE	2018-05-24
170629006172	2017-06-29	BIENNIAL STATEMENT	2016-12-01
161202000700	2016-12-02	CERTIFICATE OF CHANGE	2016-12-02

Tax Exempt

Employer Identification Number (EIN) :

46-1617561

In Care Of Name:

% NORTHWELL HEALTH INC

Classification:

Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)

Ruling Date:

2017-10

National Taxonomy Of Exempt Entities:

Health Care: Health Support Services

Deductibility:

Type of organization and use of contribution: A Type I, Type II, or functionally integrated Type III supporting organization. Deductibility Limitation: 50% (60% for cash contributions)

Determination Letters

Link:

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State