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PEDIATRIC ASSOCIATES OF WATERTOWN, P.C.

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Company Details

Name: PEDIATRIC ASSOCIATES OF WATERTOWN, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 20 Jul 1981 (44 years ago)
Entity Number: 711875
ZIP code: 13601
County: Jefferson
Place of Formation: New York
Address: 20011 SUMMIT VIEW BLVD, WATERTOWN, NY, United States, 13601

Contact Details

Phone +1 315-782-4391

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

DOS Process Agent

Name Role Address
STEPHANIE A. OLIVIA, M.D. DOS Process Agent 20011 SUMMIT VIEW BLVD, WATERTOWN, NY, United States, 13601

Chief Executive Officer

Name Role Address
STEPHANIE A. OLIVIA, M.D. Chief Executive Officer 20011 SUMMIT VIEW BLVD, WATERTOWN, NY, United States, 13601

Unique Entity ID

Unique Entity ID:
PCWKY2A42CL6
CAGE Code:
9B9L4
UEI Expiration Date:
2026-02-24

Business Information

Activation Date:
2025-02-25
Initial Registration Date:
2022-06-08

Commercial and government entity program

CAGE number:
9B9L4
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2025-02-25
CAGE Expiration:
2030-02-25
SAM Expiration:
2026-02-24

Contact Information

POC:
CARESSA FLOWERS

National Provider Identifier

NPI Number:
1497855670

Authorized Person:

Name:
DR. MARIO F. VICTORIA
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
Yes

Contacts:

Fax:
3157888319

Form 5500 Series

Employer Identification Number (EIN):
161164031
Plan Year:
2023
Number Of Participants:
27
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
24
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
20
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
21
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
22
Sponsors Telephone Number:

History

Start date End date Type Value
2025-07-01 2025-07-01 Address 20011 SUMMIT VIEW BLVD, WATERTOWN, NY, 13601, USA (Type of address: Chief Executive Officer)
2025-07-01 2025-07-01 Address 20011 SUMMIT DRIVE, WATERTOWN, NY, 13601, USA (Type of address: Chief Executive Officer)
2025-07-01 2025-07-01 Address 18969 US RTE 11, WATERTOWN, NY, 13601, USA (Type of address: Chief Executive Officer)
2023-07-05 2023-07-05 Address 18969 US RTE 11, WATERTOWN, NY, 13601, USA (Type of address: Chief Executive Officer)
2023-07-05 2023-07-05 Address 20011 SUMMIT VIEW BLVD, WATERTOWN, NY, 13601, USA (Type of address: Chief Executive Officer)

Filings

Filing Number Date Filed Type Effective Date
250701047685 2025-07-01 BIENNIAL STATEMENT 2025-07-01
230705000756 2023-07-05 BIENNIAL STATEMENT 2023-07-01
211221001755 2021-12-21 BIENNIAL STATEMENT 2021-12-21
150602002041 2015-06-02 BIENNIAL STATEMENT 2013-07-01
A782689-4 1981-07-20 CERTIFICATE OF INCORPORATION 1981-07-20

USAspending Awards / Financial Assistance

Date:
2021-03-13
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:
218059.15
Total Face Value Of Loan:
218059.15

Paycheck Protection Program

Jobs Reported:
21
Initial Approval Amount:
$218,059.15
Date Approved:
2021-03-12
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$218,059.15
Race:
White
Ethnicity:
Not Hispanic or Latino
Gender:
Female Owned
Veteran:
Non-Veteran
Forgiveness Amount:
$220,024.67
Servicing Lender:
Watertown Savings Bank
Use of Proceeds:
Payroll: $218,055.15
Utilities: $1

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Date of last update: 17 Mar 2025

Sources: New York Secretary of State