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LONG ISLAND SURGICAL SPECIALISTS, P.C.

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Company Details

Name: LONG ISLAND SURGICAL SPECIALISTS, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 07 Jul 1980 (45 years ago)
Date of dissolution: 14 May 2013
Entity Number: 637470
ZIP code: 11042
County: Nassau
Place of Formation: New York
Address: 410 LAKEVILLE RD, STE 310, LAKE SUCCESS, NY, United States, 11042

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
SANFORD DUBNER, M.D. Chief Executive Officer 410 LAKEVILLE RD, STE 310, LAKE SUCCESS, NY, United States, 11042

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 410 LAKEVILLE RD, STE 310, LAKE SUCCESS, NY, United States, 11042

National Provider Identifier

NPI Number:
1083898654

Authorized Person:

Name:
ALI PISCITELLI
Role:
BILLING SUPERVISOR
Phone:

Taxonomy:

Selected Taxonomy:
174400000X - Specialist
Is Primary:
Yes

Contacts:

Fax:
5164371212

Form 5500 Series

Employer Identification Number (EIN):
112538736
Plan Year:
2012
Number Of Participants:
8
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
1
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
10
Sponsors Telephone Number:

History

Start date End date Type Value
2008-07-16 2012-07-25 Address 410 LAKEVILLE RD, STE 310, LAKE SUCCESS, NY, 11042, USA (Type of address: Chief Executive Officer)
2006-06-07 2008-07-16 Address 410 LAKEVILLE RD, STE 310, LAKE SUCCESS, NY, 11042, USA (Type of address: Chief Executive Officer)
1992-09-29 1999-11-17 Name HELLER AND DUBNER, M.D.'S, P.C.
1980-08-14 1992-09-29 Name KEITH S. HELLER, M.D., P.C.
1980-07-07 1980-08-14 Name KEITH S. HELLER, P.C.

Filings

Filing Number Date Filed Type Effective Date
130514000167 2013-05-14 CERTIFICATE OF DISSOLUTION 2013-05-14
120725006000 2012-07-25 BIENNIAL STATEMENT 2012-07-01
100727002344 2010-07-27 BIENNIAL STATEMENT 2010-07-01
080716003300 2008-07-16 BIENNIAL STATEMENT 2008-07-01
060607002006 2006-06-07 BIENNIAL STATEMENT 2004-07-01

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Date of last update: 17 Mar 2025

Sources: New York Secretary of State