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ALBANY KETAMINE MEDICAL INFUSIONS, PLLC

Company Details

Name: ALBANY KETAMINE MEDICAL INFUSIONS, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 07 Jun 2018 (7 years ago)
Entity Number: 5355377
ZIP code: 12180
County: Rensselaer
Place of Formation: New York
Address: 96 LORENZO DR., TROY, NY, United States, 12180

DOS Process Agent

Name Role Address
ALBANY KETAMINE MEDICAL INFUSIONS, PLLC DOS Process Agent 96 LORENZO DR., TROY, NY, United States, 12180

National Provider Identifier

NPI Number:
1861065856
Certification Date:
2023-12-11

Authorized Person:

Name:
PHILIP HANSEN
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
261QI0500X - Infusion Therapy Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
5189422248

Filings

Filing Number Date Filed Type Effective Date
220408000637 2022-04-08 BIENNIAL STATEMENT 2020-06-01
180912000021 2018-09-12 CERTIFICATE OF PUBLICATION 2018-09-12
180607000480 2018-06-07 ARTICLES OF ORGANIZATION 2018-06-07

USAspending Awards / Financial Assistance

Date:
2021-03-20
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:
20833.00
Total Face Value Of Loan:
20833.00

Paycheck Protection Program

Date Approved:
2021-03-20
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
20833
Current Approval Amount:
20833
Race:
Black or African American
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
21109.82

Date of last update: 23 Mar 2025

Sources: New York Secretary of State