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  5. PARK AVENUE MEDICAL OFFICE, PLLC

PARK AVENUE MEDICAL OFFICE, PLLC

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Company Details

Name: PARK AVENUE MEDICAL OFFICE, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 18 Sep 2019 (6 years ago)
Entity Number: 5622946
ZIP code: 10065
County: New York
Place of Formation: New York
Address: 642 PARK AVENUE, NEW YORK, NY, United States, 10065

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 642 PARK AVENUE, NEW YORK, NY, United States, 10065

National Provider Identifier

NPI Number:
1013568435
Link:
View on NPI website

Authorized Person:

Name:
DR. WELLINGTON S TICHENOR
Role:
OWNER
Phone:
2125176611

Taxonomy:

Selected Taxonomy:
207RA0201X - Allergy & Immunology (Internal Medicine) Physician
Is Primary:
Yes

Contacts:

Phone:
+1 212-517-6611
Fax:
2125172132

Filings

Filing Number Date Filed Type Effective Date
191210000329 2019-12-10 CERTIFICATE OF CHANGE 2019-12-10
191210000807 2019-12-10 CERTIFICATE OF PUBLICATION 2019-12-10
190918000055 2019-09-18 ARTICLES OF ORGANIZATION 2019-09-18

USAspending Awards / Financial Assistance

Date:
2021-02-05
Link:
View on USAspending
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:
20832.00
Total Face Value Of Loan:
20832.00
Date:
2020-04-28
Link:
View on USAspending
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:
20800.00
Total Face Value Of Loan:
20800.00

Paycheck Protection Program

Jobs Reported:
1
Initial Approval Amount:
$20,800
Date Approved:
2020-04-27
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$20,800
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$20,971.53
Servicing Lender:
Loan Source Incorporated
Use of Proceeds:
Payroll: $20,800
Jobs Reported:
1
Initial Approval Amount:
$20,832
Date Approved:
2021-02-05
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$20,832
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$21,048.88
Servicing Lender:
Loan Source Incorporated
Use of Proceeds:
Payroll: $20,832

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Related by address

642 PARK AVENUE, NEW YORK, NY, United States, 10065

PARK AVENUE ENDOSCOPY, PLLC

Date of last update: 23 Mar 2025

Sources: New York Secretary of State

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