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  5. MEDIPHORE, INC.

MEDIPHORE, INC.

Company Details

Name: MEDIPHORE, INC.
Jurisdiction: New York
Legal type: FOREIGN BUSINESS CORPORATION
Status: Active
Date of registration: 26 Jul 2019 (6 years ago)
Entity Number: 5593718
ZIP code: 10017
County: New York
Place of Formation: Delaware
Address: 767 THIRD AVENUE, 25TH FLOOR, NEW YORK, NY, United States, 10017

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MEDIPHORE INC. 401(K) PROFIT SHARING PLAN AND TRUST 2021 824340234 2022-06-24 MEDIPHORE INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 541990
Sponsor’s telephone number 6468496801
Plan sponsor’s address 767 3RD AVE, NEW YORK, NY, 10017

Signature of
Role Plan administrator
Date 2022-06-24
Name of individual signing VERONIKA POMYATEEVA
MEDIPHORE INC. 401(K) PROFIT SHARING PLAN AND TRUST 2020 824340234 2021-07-30 MEDIPHORE INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 541990
Sponsor’s telephone number 6468496801
Plan sponsor’s address 767 3RD AVE, NEW YORK, NY, 10017

Signature of
Role Plan administrator
Date 2021-07-30
Name of individual signing VERONIKA POMYATEEVA
MEDIPHORE INC. 401(K) PROFIT SHARING PLAN AND TRUST 2019 824340234 2021-01-22 MEDIPHORE INC. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 541990
Sponsor’s telephone number 2123504281
Plan sponsor’s address 767 3RD AVE, NEW YORK, NY, 10017

Signature of
Role Plan administrator
Date 2021-01-22
Name of individual signing VERONIKA POMYATEEVA
MEDIPHORE INC 401 K PROFIT SHARING PLAN TRUST 2018 824340234 2019-04-11 MEDIPHORE INC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 541990
Sponsor’s telephone number 2123504281
Plan sponsor’s address 767 3RD AVE. 25TH FLOOR, NEW YORK, NY, 10017

Signature of
Role Plan administrator
Date 2019-04-11
Name of individual signing FRANCIS VAN SCOY

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 767 THIRD AVENUE, 25TH FLOOR, NEW YORK, NY, United States, 10017

Filings

Filing Number Date Filed Type Effective Date
190726000049 2019-07-26 APPLICATION OF AUTHORITY 2019-07-26

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
6950627200 2020-04-28 0202 PPP 767 Third Avenue, New York, NY, 10017
Loan Status Date 2022-02-19
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 46800
Loan Approval Amount (current) 46800
Undisbursed Amount 0
Franchise Name -
Lender Location ID 188567
Servicing Lender Name Loan Source Incorporated
Servicing Lender Address 353 East 83rd Street Suite 3H, NEW YORK, NY, 10028
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address New York, NEW YORK, NY, 10017-0001
Project Congressional District NY-12
Number of Employees 7
NAICS code 541618
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 86717
Originating Lender Name Webster Bank National Association
Originating Lender Address Pearl River, NY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 47206.45
Forgiveness Paid Date 2021-03-25
4918728410 2021-02-07 0202 PPS 767 3rd Ave, New York, NY, 10017-2023
Loan Status Date 2022-02-19
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 113102
Loan Approval Amount (current) 113102
Undisbursed Amount 0
Franchise Name -
Lender Location ID 188567
Servicing Lender Name Loan Source Incorporated
Servicing Lender Address 353 East 83rd Street Suite 3H, NEW YORK, NY, 10028
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address New York, NEW YORK, NY, 10017-2023
Project Congressional District NY-12
Number of Employees 6
NAICS code 541618
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 29599
Originating Lender Name Northeast Bank
Originating Lender Address LEWISTON, ME
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 114056.39
Forgiveness Paid Date 2021-12-22

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Related by address

767 THIRD AVENUE, 25TH FLOOR, NEW YORK, NY, United States, 10017

MAYA CAPITAL ADVISORS LLC

Date of last update: 23 Mar 2025

Sources: New York Secretary of State

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