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  5. STONY BROOK UROLOGY, UNIVERSITY FACULTY PRACTICE CORPORATION

STONY BROOK UROLOGY, UNIVERSITY FACULTY PRACTICE CORPORATION

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Company Details

Name: STONY BROOK UROLOGY, UNIVERSITY FACULTY PRACTICE CORPORATION
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 04 May 1983 (42 years ago)
Entity Number: 839621
ZIP code: 11794
County: Suffolk
Place of Formation: New York
Principal Address: HEALTH SCIENCE CENTER LEVEL 5, ROOM 048 SUNY AT STONY BROOK, STONY BROOK, NY, United States, 11794
Address: HEALTH SCIENCES CTR L5 RM 048, STONY BROOK UNIVERSITY, STONY BROOK, NY, United States, 11794

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
WAYNE C. WALTZER, M.D. Chief Executive Officer PO BOX 1554, STONY BROOK, NY, United States, 11790

DOS Process Agent

Name Role Address
STONY BROOK UROLOGY, UFPC / CLINICAL PRACTICE MANAGEMENT PLAN DOS Process Agent HEALTH SCIENCES CTR L5 RM 048, STONY BROOK UNIVERSITY, STONY BROOK, NY, United States, 11794

National Provider Identifier

NPI Number:
1538114707
Link:
View on NPI website

Authorized Person:

Name:
WAYNE WALTZER
Role:
CHAIR PERSON
Phone:
6314441252

Taxonomy:

Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
No
Selected Taxonomy:
208800000X - Urology Physician
Is Primary:
Yes

Contacts:

Phone:
+1 631-444-1252
Phone:
+1 631-444-6270

History

Start date End date Type Value
2022-03-18 2023-07-20 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
1993-07-07 2006-06-23 Address BOX AK, STONY BROOK, NY, 11790, USA (Type of address: Service of Process)
1993-04-12 1993-07-07 Address PO BOX 1554, STONY BROOK, NY, 11790, USA (Type of address: Chief Executive Officer)
1993-04-12 1993-07-07 Address HEALTH SCIENCE CENTER-LEVEL 5, ROOM 048 - SUNY AT STONY BROOK, STONY BROOK, NY, 11794, USA (Type of address: Principal Executive Office)
1983-05-04 2022-03-18 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
060623000191 2006-06-23 CERTIFICATE OF REINCORPORATION 2006-06-23
050714002059 2005-07-14 BIENNIAL STATEMENT 2005-05-01
030610002574 2003-06-10 BIENNIAL STATEMENT 2003-05-01
010620002341 2001-06-20 BIENNIAL STATEMENT 2001-05-01
990823002515 1999-08-23 BIENNIAL STATEMENT 1999-05-01

USAspending Awards / Financial Assistance

Date:
2020-05-03
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:
366903.00
Total Face Value Of Loan:
366903.00

Tax Exempt

Employer Identification Number (EIN) :
11-2644371
In Care Of Name:
% SB CLINICAL PRAC MGMT PLAN I
Classification:
Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Ruling Date:
2008-02
National Taxonomy Of Exempt Entities:
Health Care: Hospitals and Related Primary Medical Care Facilities
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Paycheck Protection Program

Jobs Reported:
19
Initial Approval Amount:
$366,903
Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$366,903
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$369,325.57
Servicing Lender:
Bank of America, National Association
Use of Proceeds:
Payroll: $366,903

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HEALTH SCIENCES CTR L5 RM 048, STONY BROOK UNIVERSITY, STONY BROOK, NY, United States, 11794

NEUROLOGY ASSOCIATES OF STONY BROOK, UNIVERSITY FACULTY PRACTICE CORPORATION NEW YORK SPINE & BRAIN SURGERY, UNIVERSITY FACULTY PRACTICE CORPORATION STONY BROOK CHILDREN'S SERVICE UNIVERSITY FACULTY PRACTICE CORPORATION STONY BROOK DERMATOLOGY ASSOCIATES, UNIVERSITY FACULTY PRACTICE CORPORATION STONY BROOK EMERGENCY PHYSICIANS, UNIVERSITY FACULTY PRACTICE CORPORATION STONY BROOK FAMILY AND PREVENTIVE MEDICINE, UNIVERSITY FACULTY PRACTICE CORPORATION STONY BROOK INTERNISTS, UNIVERSITY FACULTY PRACTICE CORPORATION STONY BROOK OPHTHALMOLOGY, UNIVERSITY FACULTY PRACTICE CORPORATION STONY BROOK ORTHOPAEDIC ASSOCIATES, UNIVERSITY FACULTY PRACTICE CORPORATION STONY BROOK PATHOLOGISTS, UNIVERSITY FACULTY PRACTICE CORPORATION

Date of last update: 17 Mar 2025

Sources: New York Secretary of State

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