Schoolcraft v. The City Of New York et al

Filing 401

FILING ERROR - DUPLICATE DOCKET ENTRY - DECLARATION of NATHANIEL B. SMITH in Opposition re: 297 MOTION for Summary Judgment .. Document filed by Adrian Schoolcraft. (Attachments: # 1 Exhibit POX 40, # 2 Exhibit POX 41, # 3 Exhibit POX 42, # 4 Exhibit POX 45, # 5 Exhibit POX 46, # 6 Exhibit POX 47, # 7 Exhibit POX 48, # 8 Exhibit POX 49)(Smith, Nathaniel) Modified on 2/17/2015 (db).

2/6/2015

Entity Information

NYS Department of State
Division of Corporations
Entity Information
The information contained in this database is current through February 5, 2015.
Selected Entity Name: THE JAMAICA HOSPITAL MEDICAL CENTER DIAGNOSTIC AND
TREATMENT CENTER CORPORATION
Selected Entity Status Information
Current Entity THE JAMAICA HOSPITAL MEDICAL CENTER DIAGNOSTIC AND
Name:
TREATMENT CENTER CORPORATION
1984641
DOSID#:
Initial DOS
DECEMBER 26, 1995
Filing Date:
QUEENS
County:
Jurisdiction: NEW YORK
Entity Type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Current Entity
ACTIVE
Status:
Selected Entity Address Information
DOS Process (Address to which DOS will mail process if accepted on behalf of the entity)
THE JAMAICA HOSPITAL MEDICAL CENTER DIAGNOSTIC AND TREATMENT CENTER
CORPORATION
8900 VANWYCK EXPRESSWAY
JAMAICA, NEW YORK, 11418
Registered Agent
NONE
This office does not record information regarding
the names and addresses of officers, shareholders or
directors of nonprofessional corporations except the
chief executive officer, if provided, which would be
listed above. Professional corporations must include
the name(s) and address(es) of the initial officers,
directors, and shareholders in the initial certificate of

I

i-;.

http://appext20 .dos .ny .gov /corp_public/CORPSEARCH.ENTITY _INFORMATION?p_nameid=2044238&p_corpid=l984641 &p_entity _name=%54%68%65%20%4. . .

112

2/6/2015

Entity Information

incorporation, however this information is not
recorded and only available by viewing the
certificate.
*Stock Information
#of Shares

Type of Stock
$ Value per Share
No Information Available

*Stock information is applicable to domestic business corporations.
Name History
Filing
Name
Entity Name
Date
Type
DEC 26,
Actual THE JAMAICA HOSPITAL MEDICAL CENTER DIAGNOSTIC AND
TREATMENT CENTER CORPORATION
1995
A Fictitious name must be used when the Actual name of a foreign entity is unavailable for use in New
York State. The entity must use the fictitious name when conducting its activities or business in New
York State.
NOTE: New York State does not issue organizational identification numbers.
Search Results New Search
Services/Programs I Privacy Policy I Accessibility Policy I Disclaimer I Return to DOS
Homepage I Contact Us

http://appext20 .dos .ny .gov/corp_public/CORPSEARCH.ENTITY_INFORMATION?p_nameid=2044238&p_corpid=l984641 &p_entity_name=%54%68%65%20%4...

2/2

Registration Statement for Charitable Organizations
New York State Department of Law (Office of the At_tomey General)
Charilies Bureau - Reglstralion Section
120 Broadway
New York, NY 10271
www.oag.slate.ny.I,Js/charitieslcharilies.html

Part A
1.

~ Jdent!flcaUon (:If R.egh;trapt

'

Full name of organization (exactly as it appears in your organizing document)

c/o Name (if applicable)

Fed. employer ID no. (EIN)

5.

The Jamaica Hospital Medical Center Diagnostic
and Treatment Center Corporation
2.

Open to Public
Inspection

.l l - ..3 ..3. ..4.. .0. .9.. 6... g_
6. Organization's website

www.medisyshealth.org
3.

Room/suite

Mailing address (Number and street)

8900 Van Wyck

E~ressway

7.

45

Manzar Sass ani

City or town, stale or country and ZIP+4

Jamaica, NY

Primary contact

Title

11418

Assistant Treasurer

4. Principal NYS address (Number and street)

Room/suiie

8900 Van Wyck Expressway

48

Phone

City or town, state or country and ZIP+4

Jamaica, NY

Fax

718-206-6291

718-206-6299

Email

11418

[e-mail]

We certify under penaltles for perjury that we reviewed this Registration Statement, including all schedules and attachments, and to the best of our
knowledge and belief. they are true, correct and

· · ,.

·

.· .

·" .····

.1,, Pr~~~~ent 9r }\u!Qo~?;ed Of{icer{f!J:!s!!ll'l. :
· .....

"

,... ·

... '

·

.. · • •·•·• · · ... , ·

m Jete i, wrdance with the laws of the State of New York applicable to this statement.
"'

Sign ure

/.

V

~

David Rosen

President

. Printed Name

\

TiUe

Mounir Doss

Treasurer/CFO
Tille

Printed Name

_
·:~.·-

.

. ... . ~..... ... .
:

If registering to solicit contributions, fee is $25.
If not registering to solicit contributions, no fee is owed.

~Check.::;:>~

if you are submitting $25 fee to
register to solicit contributions.

".':··.. :
.·

__

I

Submit check or money order,
payable to "NYS Department of Law."

Attach all of the following documents to this Registration Statement, even if you are claiming an exemption from registration:
Certificate of Incorporation, trust agreement or other organizing document, and any amendments; and
Bylaws or other organizational rules, and any amendments; and
IRS Form 1023 or 1024 Application for Recognition of Exemption (if applicable); and
IRS tax exemption determination letter (If applicable)

Part E - Request for> Regl~tr~tlon Exempt!9n·
:
.
.
,, .
·• · .•. ·•
•
.•..
Is the organization requesting exemption from registration under either or both Article 7-A or the EPTL? .........................

0

Yes• ~No

• If "Yes", complete Schedule E.

Page 1 of3

Form CHAR410 (2004)

.. ·. ·;;·

···~·

1.

Incorporation I formation
a. Type of organization:
Corporation ........................................

XI

Limited liability company (LLC) ......•......••......•... 0
Partnership ........................................ 0
Sole proprietorship . . . . . . • . . • . . . . . • . . . . . . . . . . . • . . . . . . 0
Trust ....................................•........ 0
Unincorporated association . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Other • •........•..........•...................•...
• If Other, describe;
2.

b. Type of corporation if New York not-for-profit corporation
A0
I:X C 0 0 0
8

1--------------------------1
c.

Date Incorporated if a corporation or formed if other than a corporation

l--_1_2_12_6__1_L_L_9_5 _ _ _ _ _ _ _ _ _--I
_

0 d. State in which incorporated or formed
0

New York

List all chapters, branches and affiliates of your organization (attach additional sheets if necessary)

Name

Relationship

Mailing address (number and street, room/suite,
City or town, state or country and zip+4)

None

3. List all officers, directors, trustees and key employees
Name

Tille

Mailing address (number and street, room/suite,
city or town, state or country and zip+4)

End of term
(if applicable)

See Attachment #1

,,
4.

Other Names and Registration Numbers
a.

List all other names used by your organization, including any prior names

MediSys Family Care Centers (a d/b/a)
b.

List all prior New York State charities registration numbers for the organization, including those from the New York State Attorney General's
Charities Bureau or the New York Stale Department of Slate's Office of Charities Registration

None

Page2of3

Form CHAR410 (2004)

.

~~rt ~ : :P.t~"lri~HPpiA.pt!vltl~s
1.

·...

Month lhe annual accounting period ends (01-12)

··

2. NTEE code

12

E32

3. Dale organization bagan doing each of following In New York Slate:
a.

conducting activity ...........•••..•........................•.•.•........•................•.... ~2.__ I .2.. ..6.1 L 9_ ..9.. ...5.

b.

4.

maintaining assets ............................................................................

c.

soliciting contributions (including from residents. foundations. corporations, government agericies, etc.) .. ~./.~...

_lL 1£ .2.1L2....2.2.
-- I -- I - - - -

Describe the purposes of your organization

See Attachment 112

5. Has your organization or any of your officers, directors, trustees or key employees been:

·········· ...............

DYes* ~No

. .......

[J Yes• SNo

....... ·················· .....

DYes* !»No

a.

enjoined or otherwise prohibited by a government agency or court from soliciting contributions?
• If "Yes", describe:

b.

found to have engaged in unlawful practices In conneclion with the solicitation or administration of charitable assets?
• If "Yes", describe;

6. Has your organization's registration or license been suspended by any government agency?
* If "Yes", describe;

7. Does your organization solicit or intend to solicit contributions (including from residents, foundations, corporations, government

. .... ·.......................................................................:ZO Yes*

agencies, etc.) in New York State?
*If "Yes", describe the purposes for which contributions are or will be solicited:

8.

List all fund raising professionals (FRP) that your organization has engaged for fund raising activity in NY Slate (attach additional sheets if
necessary)
Name

None

Type ofFRP
(see Instructions for definitions)
PFR
FRC
CCV

. ··············· 0

···············.
................

0
0

PFR
FRC
CCV

................
................
················

0
0
0

PFR
FRC
CCV

1.

................ 0
........ ········ 0

................

0

Mailing address (number and street, room/suite,
city or town, stale or country and zip+4)

Dales of contract
Start dale:

-----------------------------------

End dale:
Start date:

-----------------------------------

.

End date:
Start date:

-----------------------------------

End date:

-- I -- I ----- I -- I ----

-- I -- I ----- I -- I ----

-- I -- I ----- I -- I ----

If applicable, list the dale your organization:
a.

applied for tax exempt status . . . . . . . . . . . . . . . . . . . . . . . . • • • • . . • . . • . • • . . . . . . . • . . . . . . . • . . • . . . . . . . . . . . . _ _ I __ I _ _ _ _

b. was granted tax exempt status

00

••

00

00

••

00

00

•

00

•••••

00

....

00

•

00

00

•

00

•

00

00

....

00

••••

00

•••

00

••

00

•

•

c.

..L~ 11_ ~-.1.11. 'L ~

was denied tax exempt status ..........•..•............••.•••.....•........•....................

d.
2.

DNa

had its tax exempt status revoked ............•..........................•........................

Provide Internal Revenue Code provision:

501(c)( ...3-l

Page3of3

Form CHAR410 (2004)

81100 Von l\l)'ck Exptesowoy. Jamolc• N.Y. 11418

{7t8l 206-60011

JAMAICA HOSPITAL MEDICAL CENTER
DIAGNOSTIC & TREATMENT CENTER CORP.
BOARD OF TRUSTEES

i
I
I
I

•

Geraldine M. Chapey, Ph.D.
Anthony DiMaria, M.D., Secretary
Geoffrey Doughlin, M.D., Third Vice Chairman
Hon. Timothy J. Dufficy
Hector Estepan, M.D.
Joseph Ferrara, Assistant Treasurer
Robert W. Koop, Second Vice Chairman & Treasurer
John Marus, First Vice Chairman
Antonietta Morisco, M.D.
Neil Foster Phillips, Chairman
William Doug Singer
Archie Spigner, Assistant Secretary

The Jamaica Hospital Medical Center Diagnostic and Treatment Center Corporation
EIN: 11-3340969
Attachment #2

The Jamaica Hospital Medical Center Diagnostic and Treatment Center Corporation (the
"Registrant") was formed to operate a network of ambulatory care centers as part of the health
care network for the use of staff and employees of The Jamaica Hospital Medical Center (the
"Hospital"), a 384-bed voluntary, not-for-profit, acute care hospital in Jamaica, Queens.
Founded in 1891, the Hospital has a long history of providing quality services to low-income
residents of southern Queens and Brooklyn, New York. The New York State Department of
Health has designated the Hospital as a "financially distressed hospital." This designation
acknowledges the critical role the Hospital plays in providing health care services to low-income
.and uninsured members of its community, who often have no means to pay for such services. It
maintains a 24-hour emergency room open to all persons without regard to their ability to pay. It
currently employs more than 3,000 people and serves .a population greater than 1.2 million,
principally in Queens and eastern Brooklyn. More information about the Hospital can be
obtained from its website, www.jamaicahospital.org
The Registrant's facilities provide general Pediatric, Medical, Family Practice and
Obstetrical/Gynecological services. Other services that are available and vary from site to site are
Nutrition, WIC, Mental Health, Social Services, Cardiology, Urology, Orthopedics, Neurology,
Surgery, Dermatology, Podiatry, Gastroenterology, Geriatrics, Dental, Otolaryngology and
Pulmonary Rehabilitation. Below is a listing of these facilities and some of the services they
offer:
Astoria Facility

4-21 27th Avenue
Astoria, NY 11101
718-278-6885
Pediatrics, Ob/Gyn, Internal Medicine, Podiatry, X-ray, Counseling
East New York Facility

3080 Atlantic Avenue
Brooklyn, NY 11208
718-647-0240
Family Practice, Medicine, Pediatrics, Obstetrics/Gynecology, Dental, Ophthalmology,
Podiatry, Radiology, Counseling
Hollis Facility

188-03 Jamaica Avenue
Hollis, NY 11423
718-740-2060

Pediatrics, Ob/Gyn, Internal Medicine, Podiatry, X-ray, Counseling
Hollis Tudors Facility

200-16 Hollis Avenue
Hollis, NY 11423
718-736-8204
Pediatrics, Ob/Gyn, Internal Medicine, Podiatry, X-ray, Counseling
Howard Beach Facility

. 157-02 Cross Bay Blvd
Howard Beach, NY 11414
718-323-3590
Pediatrics,

Obstetrics/Gynecol~gy

Jamaica Facility

90-16 Sutphin Blvd
Jamaica, NY 11435
718-523-5500
Pediatrics, Ob/Gyn, Internal Medicine, Podiatry, X-ray, Counseling
Ozone Park Facility

91-20 Atlantic Avenue
Ozone Park, NY 11421
718-641-8207
Pediatrics, Medicine, Family Practice, Ob/Gyn, Podiatry, Radiology, Counseling
Richmond Hill Facility

133-03 Jamaica Avenue
Richmond Hill, NY 11418
718-657-7093
Family Practice, Medicine, Pediatrics, Obstetrics/Gynecology, Dental, Radiology,
Counseling

2

St.Aibans Facility

111-20 Merrick Blvd.
St. Albans, NY 11433
718-206-9888
Family Practice, Medicine, Pediatrics, Obstetrics/Gynecology, Dental, Ophthalmology,
Surgery, Urology, Podiatry, Counseling

Senior Health Center
91-20 Atlantic Avenue
Suite 1 ground floor
Ozone Park, NY 11421
718-529-6241
Geriatrics, Internal Medicine
Women's Health Center

133-03 Jamaica Avenue
Jamaica, NY 11418
718-291-3276
Obstetrics, Gynecology, Health and Breast Screenings, Marrimography, Sonography,
Bone Densitometry

3