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PARK AVENUE MEDICAL OFFICE, PLLC

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

Authorized Person:

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

Taxonomy:

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

Contacts:

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
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
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

Date Approved:
2020-04-27
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
20800
Current Approval Amount:
20800
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
20971.53
Date Approved:
2021-02-05
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
20832
Current Approval Amount:
20832
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
21048.88

Date of last update: 23 Mar 2025

Sources: New York Secretary of State