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JA MEDICAL P.C.

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Company Details

Name: JA MEDICAL P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 29 Oct 2020 (5 years ago)
Entity Number: 5867967
ZIP code: 08873
County: Suffolk
Place of Formation: New York
Address: 97 Cedar Grove Lane, SOMERSET, NJ, United States, 08873
Principal Address: 161 East Main Street, Huntington, NY, United States, 11743

Contact Details

Phone +1 631-760-8207

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
JA MEDICAL P.C. DOS Process Agent 97 Cedar Grove Lane, SOMERSET, NJ, United States, 08873

Chief Executive Officer

Name Role Address
DR JALIL ANWAR Chief Executive Officer 161 EAST MAIN STREET, HUNTINGTON, NY, United States, 11743

National Provider Identifier

NPI Number:
1285224238
Certification Date:
2021-01-23

Authorized Person:

Name:
DR. JALIL ANWAR
Role:
PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
207RC0200X - Critical Care Medicine (Internal Medicine) Physician
Is Primary:
No
Selected Taxonomy:
207RP1001X - Pulmonary Disease Physician
Is Primary:
Yes

Contacts:

Fax:
6315491084

Form 5500 Series

Employer Identification Number (EIN):
854056308
Plan Year:
2023
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
0
Sponsors Telephone Number:

History

Start date End date Type Value
2021-01-21 2024-03-07 Address 161 EAST MAIN ST., HUNTINGTON, NY, 11743, USA (Type of address: Service of Process)
2020-10-29 2024-03-07 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2020-10-29 2021-01-21 Address 4 SAVINGS CT., GREENLAWN, NY, 11740, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240307001112 2024-03-07 BIENNIAL STATEMENT 2024-03-07
210121000340 2021-01-21 CERTIFICATE OF CHANGE 2021-01-21
201029000445 2020-10-29 CERTIFICATE OF INCORPORATION 2020-10-29

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Date of last update: 22 Mar 2025

Sources: New York Secretary of State