FORM 1023-EZ for NEW YORK STATE ASSOCIATION OF ENDOCRINOLOGY INC

Field Data
EIN 86-2069627
Case Number EO-2021102-000315
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NEW YORK STATE ASSOCIATION OF ENDOCRINOLOGY INC
Organization’s Mailing Address 6080 JERICHO TURNPIKE SUITE 314
City COMMACK
State NY
ZIP 11725
Accounting period End 12
Primary contact name PETER BIRZON ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EDWARD CONDON MD
DIRECTOR
6080 JERICHO TURNPIKE
COMMACK NY 11725

Officer/Director/Trustee Two

JOSEPH TIBALDI MD
DIRECTOR
174-15 HORACE HARDING EXPRESSWAY
FRESH MEADOWS NY 11365

Officer/Director/Trustee Three

MARTIN GRAJOWER MD
DIRECTOR
3736 HENRY HUDSON PARKWAY
BRONX NY 10463

Officer/Director/Trustee Four

SUSAN WASSERMAN MD
DIRECTOR
560 NORTHERN BLVD
GREAT NECK NY 11021

Organization’s website NONE
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/4/2021
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A03 - Professional Societies, Associations
Organization’s purpose Charitable: No
Religious: No
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 No
Donation of funds No
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name EDWARD CONDON MD
Signature Title DIRECTOR
Signature Date 4/1/2021

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