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WILLIAM J. LACKEY, M.D., P.C.

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Company Details

Name: WILLIAM J. LACKEY, M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 28 Jul 2015 (10 years ago)
Entity Number: 4795682
ZIP code: 10011
County: New York
Place of Formation: New York
Address: 14 WEST 10TH STREET, STE. #3W, NEW YORK, NY, United States, 10011

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 14 WEST 10TH STREET, STE. #3W, NEW YORK, NY, United States, 10011

National Provider Identifier

NPI Number:
1760967723

Authorized Person:

Name:
MRS. ELIZABETH GOFAYZEN
Role:
BILLING MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207XS0114X - Adult Reconstructive Orthopaedic Surgery Physician
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
463740300
Plan Year:
2023
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
8
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
8
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
8
Sponsors Telephone Number:

Filings

Filing Number Date Filed Type Effective Date
150728000103 2015-07-28 CERTIFICATE OF INCORPORATION 2015-07-28

Paycheck Protection Program

Jobs Reported:
8
Initial Approval Amount:
$104,717
Date Approved:
2021-04-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$104,717
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$105,589.29
Servicing Lender:
JPMorgan Chase Bank, National Association
Use of Proceeds:
Payroll: $104,715
Utilities: $1

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Date of last update: 25 Mar 2025

Sources: New York Secretary of State