FORM 1023-EZ for ASSOCIATION OF PHYSICIANS IN PRIVATE PRACTICE INC

Field Data
EIN 81-4577058
Case Number EO-2017324-000060
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ASSOCIATION OF PHYSICIANS IN PRIVATE PRACTICE INC
Organization’s Mailing Address 213 MADISON AVENUE 304
City NEW YORK
State NY
ZIP 10016
Accounting period End 12
Primary contact name HAROLD FRIEDMAN CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DANIEL ROSHAN
DIRECTOR
1 ORCHARD LANE
GREAT NECK NY 11024

Officer/Director/Trustee Two

IRA JAFFE
DIRECTOR
9 EAST 16TH STREET 5B
NEW YORK NY 10003

Officer/Director/Trustee Three

JOHN MIGOTSKY
DIRECTOR
30 WEST 63RD STREET 22J
NEW YORK NY 10023

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/28/2016
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E03 - Professional Societies, Associations
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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