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A. KHAN PHYSICIAN, P.C.

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Company Details

Name: A. KHAN PHYSICIAN, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 24 May 2017 (8 years ago)
Entity Number: 5142664
ZIP code: 11572
County: Nassau
Place of Formation: New York
Address: 187 DOT CT E, OCEANSIDE, NY, United States, 11572

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
DR. AIJAZ KHAN DOS Process Agent 187 DOT CT E, OCEANSIDE, NY, United States, 11572

Chief Executive Officer

Name Role Address
DR. AIJAZ KHAN Chief Executive Officer 187 DOT CT E, OCEANSIDE, NY, United States, 11572

National Provider Identifier

NPI Number:
1710491592

Authorized Person:

Name:
DIANE VALVA
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
5164041660

Form 5500 Series

Employer Identification Number (EIN):
821723660
Plan Year:
2023
Number Of Participants:
8
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
7
Sponsors Telephone Number:

History

Start date End date Type Value
2017-05-24 2024-01-08 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2017-05-24 2024-01-08 Address 187 DOT CT E, OCEANSIDE, NY, 11572, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240108000063 2024-01-08 BIENNIAL STATEMENT 2024-01-08
170524000468 2017-05-24 CERTIFICATE OF INCORPORATION 2017-05-24

Paycheck Protection Program

Jobs Reported:
2
Initial Approval Amount:
$23,086
Date Approved:
2021-04-29
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$23,086
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$23,237.17
Servicing Lender:
A10Capital, LLC
Use of Proceeds:
Payroll: $23,080
Utilities: $1
Jobs Reported:
2
Initial Approval Amount:
$11,958.32
Date Approved:
2020-04-29
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$11,958.32
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$12,070.37
Servicing Lender:
Idaho First Bank
Use of Proceeds:
Payroll: $11,958.32

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Date of last update: 24 Mar 2025

Sources: New York Secretary of State