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NEW YORK ISPINE SPECIALIST MEDICAL P.C.

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Company Details

Name: NEW YORK ISPINE SPECIALIST MEDICAL P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 09 Jul 2015 (10 years ago)
Entity Number: 4787200
ZIP code: 11753
County: Nassau
Place of Formation: New York
Address: 11 Holiday Pond Rd, Jericho, NY, United States, 11753
Principal Address: 135 Woodfield Rd, West Hempstead, NY, United States, 11552

Contact Details

Phone +1 516-441-5739

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 11 Holiday Pond Rd, Jericho, NY, United States, 11753

Chief Executive Officer

Name Role Address
MADANKUMAR RAJ Chief Executive Officer 11 HOLIDAY POND RD, JERICHO, NY, United States, 11791

National Provider Identifier

NPI Number:
1144604539

Authorized Person:

Name:
MADAN K RAJ
Role:
MD
Phone:

Taxonomy:

Selected Taxonomy:
208VP0000X - Pain Medicine Physician
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
474507961
Plan Year:
2019
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
4
Sponsors Telephone Number:

History

Start date End date Type Value
2025-07-02 2025-07-02 Address 11 HOLIDAY POND RD, JERICHO, NY, 11791, USA (Type of address: Chief Executive Officer)
2024-10-01 2025-07-02 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-10-01 2025-07-02 Address 11 HOLIDAY POND RD, JERICHO, NY, 11791, USA (Type of address: Chief Executive Officer)
2024-10-01 2025-07-02 Address 11 Holiday Pond Rd, Jericho, NY, 11753, USA (Type of address: Service of Process)
2023-09-25 2024-10-01 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
250702001964 2025-07-02 BIENNIAL STATEMENT 2025-07-02
241001041943 2024-10-01 BIENNIAL STATEMENT 2024-10-01
150709000729 2015-07-09 CERTIFICATE OF INCORPORATION 2015-07-09

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:
53610.00
Total Face Value Of Loan:
53610.00
Date:
2020-04-19
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
5000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00

Paycheck Protection Program

Jobs Reported:
60
Initial Approval Amount:
$53,610
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$53,610
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$53,998.2
Servicing Lender:
JPMorgan Chase Bank, National Association
Use of Proceeds:
Payroll: $42,888
Utilities: $722
Rent: $10,000

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Date of last update: 25 Mar 2025

Sources: New York Secretary of State