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COMMUNITY MEDICAL WELLNESS P.C.

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Company Details

Name: COMMUNITY MEDICAL WELLNESS P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 19 Apr 2018 (7 years ago)
Entity Number: 5326042
ZIP code: 11749
County: Suffolk
Place of Formation: New York
Address: 1050 Old Nichols Rd, Islandia, NY, United States, 11749
Principal Address: 4003 JEAN AVE, BETHPAGE, NY, United States, 11714

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
COMMUNITY MEDICAL WELLNESS P.C. DOS Process Agent 1050 Old Nichols Rd, Islandia, NY, United States, 11749

Chief Executive Officer

Name Role Address
ROBERT ANTONIOU MD Chief Executive Officer 2 BLUFF RD, ST JAMES, NY, United States, 11780

National Provider Identifier

NPI Number:
1073002473

Authorized Person:

Name:
MR. CHRISTOPHER DEFILIPPIS
Role:
OPERATIONS MANAGER
Phone:

Taxonomy:

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

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
825379331
Plan Year:
2023
Number Of Participants:
52
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
47
Sponsors Telephone Number:

History

Start date End date Type Value
2025-06-06 2025-06-28 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2025-04-07 2025-06-06 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-08-06 2024-08-06 Address 2 BLUFF RD, ST JAMES, NY, 11780, USA (Type of address: Chief Executive Officer)
2024-08-06 2025-04-07 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-08-06 2024-08-06 Address 15 BRAEMER ROAD, EAST SETAUKET, NY, 11733, USA (Type of address: Chief Executive Officer)

Filings

Filing Number Date Filed Type Effective Date
240806003357 2024-08-06 BIENNIAL STATEMENT 2024-08-06
220517001866 2022-05-17 BIENNIAL STATEMENT 2022-04-01
201214002007 2020-12-14 AMENDMENT TO BIENNIAL STATEMENT 2020-04-01
200818060243 2020-08-18 BIENNIAL STATEMENT 2020-04-01
180419000629 2018-04-19 CERTIFICATE OF INCORPORATION 2018-04-19

Paycheck Protection Program

Jobs Reported:
35
Initial Approval Amount:
$241,200
Date Approved:
2020-04-14
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$241,200
Race:
Unanswered
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$197,907.37
Servicing Lender:
Citibank, N.A.
Use of Proceeds:
Payroll: $241,200

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Date of last update: 24 Mar 2025

Sources: New York Secretary of State