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SIUC MEDICAL, P.C.

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Company Details

Name: SIUC MEDICAL, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 24 Nov 2015 (10 years ago)
Entity Number: 4854875
ZIP code: 10041
County: New York
Place of Formation: New York
Address: 55 Water Street- 9th Floor, New York, NY, United States, 10041
Principal Address: 55 WATER STREET, 9TH FLOOR Tax Department, NEW YORK, NY, United States, 10041

Contact Details

Phone +1 646-680-5200

Phone +1 646-680-5250

Shares Details

Shares issued 1000

Share Par Value 1

Type PAR VALUE

DOS Process Agent

Name Role Address
SIUC MEDICAL, P.C. DOS Process Agent 55 Water Street- 9th Floor, New York, NY, United States, 10041

Chief Executive Officer

Name Role Address
NAVARRA RODRIGUEZ, M.D. Chief Executive Officer 55 WATER STREET, 2ND FLOOR, NEW YORK, NY, United States, 10041

National Provider Identifier

NPI Number:
1467826594
Certification Date:
2024-02-07

Authorized Person:

Name:
NAVARRA RODRIGUEZ
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
261QU0200X - Urgent Care Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QM1300X - Multi-Specialty Clinic/Center
Is Primary:
Yes

Contacts:

History

Start date End date Type Value
2023-11-13 2023-11-13 Address 55 WATER STREET, 2ND FLOOR, NEW YORK, NY, 10041, USA (Type of address: Chief Executive Officer)
2019-11-26 2023-11-13 Address C/O ADVANTAGECARE PHYSICIANS, 55 WATER STREET -13TH FLOOR, NEW YORK, NY, 10041, USA (Type of address: Service of Process)
2019-11-26 2023-11-13 Address 55 WATER STREET, 2ND FLOOR, NEW YORK, NY, 10041, USA (Type of address: Chief Executive Officer)
2019-02-05 2019-02-12 Name WATER STREET MEDICAL, P.C.
2018-08-30 2019-11-26 Address 55 WATER STREET, 12TH FLOOR, NEW YORK, NY, 10041, USA (Type of address: Principal Executive Office)

Filings

Filing Number Date Filed Type Effective Date
231113001056 2023-11-13 BIENNIAL STATEMENT 2023-11-01
211105000615 2021-11-05 BIENNIAL STATEMENT 2021-11-05
191126060207 2019-11-26 BIENNIAL STATEMENT 2019-11-01
190212000064 2019-02-12 CERTIFICATE OF AMENDMENT 2019-02-12
190205000153 2019-02-05 CERTIFICATE OF AMENDMENT 2019-02-05

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Date of last update: 25 Mar 2025

Sources: New York Secretary of State