STRATEGY STUDIO / PUBLIC DATA EXPLORER

STONY BROOK UROLOGY UNIVERSITY FACULTY PRACTICE CORPORATION: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
STONY BROOK UROLOGY UNIVERSITY FACULTY PRACTICE CORPORATION (EIN 11-2644371)
Tax period
2018-07-01 to 2019-06-30
Filed
2020-06-26
IRS object ID
202011789349301616
Schema version
2018v3.3
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2020-06-26T16:25:07-05:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15 TIMES SQUAREAddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10036ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN112644371EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1STONY BROOK UROLOGYBusinessNameLine1Txt
Business Name Line2University Faculty Practice CorporationBusinessNameLine2Txt
FieldValueIRS element (for citing)
In Care Of% SB CLINICAL PRAC MGMT PLAN IInCareOfNm
Business Name ControlSTONBusinessNameControlTxt
Phone6314442055PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1554AddressLine1Txt
CityStony BrookCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11790ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonWAYNE WALTZER MDPersonNm
Person TitlePRESIDENT & DIRECTORPersonTitleTxt
Phone6314442055PhoneNum
Signature2020-06-03SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLAURA KIELCZEWSKIPreparerPersonNm
PTINP00740769PTIN
Phone2127733000PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address73.29.142.225IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id26308520201785000092FederalOriginalSubmissionId
Federal Original Submission Id2020-06-26FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id047C777BBD395ADD529156C75D94AFF56594489CAtSubmissionCreationDeviceId
At Submission Filing Device Id2979594631CB5427DBABEAFA59DA989879D1FE14AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerWayne Waltzer MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1554AddressLine1Txt
CityStony BrookCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11790ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$12,732,501GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1983FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionProvide clinical instruction to and supervision of medical students, interns and residents and, incident thereto, rendering professional services.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee17TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$11,836,346PYProgramServiceRevenueAmt
CY Program Service Revenue$12,720,541CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$6,824PYOtherRevenueAmt
CY Other Revenue$11,960CYOtherRevenueAmt
PY Total Revenue$11,843,170PYTotalRevenueAmt
CY Total Revenue$12,732,501CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$4,568,134PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$4,871,754CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$6,831,328PYOtherExpensesAmt
CY Other Expenses$8,022,790CYOtherExpensesAmt
PY Total Expenses$11,399,462PYTotalExpensesAmt
CY Total Expenses$12,894,544CYTotalExpensesAmt
PY Revenues Less Expenses$443,708PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$162,043CYRevenuesLessExpensesAmt
Total Assets BOY$2,272,485TotalAssetsBOYAmt
Total Assets EOY$2,110,442TotalAssetsEOYAmt
Total Liabilities BOY$2,272,485TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,110,442TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$0NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$0NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE CLINICAL INSTRUCTION TO AND SUPERVISION OF MEDICAL SCHOOL STUDENTS, INTERNS AND RESIDENTS AND, INCIDENT THERETO, RENDERING PROFESSIONAL SERVICES.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$11,320,793ExpenseAmt
Grant$0GrantAmt
Revenue$12,720,541RevenueAmt
DescThe organization provides services in the field of Urology to patients and provides clinical instruction to and supervision of School of Medicine students and Hospital residents.Desc
Total Program Service Expenses$11,320,793TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
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Grant To Related PersonfalseGrantToRelatedPersonInd
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Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee17EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonSB CLINICAL PRAC MGMT PLAN IPersonNm
Phone6314442055PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1554AddressLine1Txt
CityStony BrookCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11790ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Wayne Waltzer
President & Director40.010.0Yes (X)Yes (X)$757,802$255,547$91,104
Robert Wasnick
Secretary & Director40.010.0Yes (X)Yes (X)$151,198$144,241$54,978
Sadar Ali Khan
Director40.010.0Yes (X)$93,426$170,501$52,609
Frank Darras
Urologist40.010.0$394,631$222,241$76,598Yes (X)
JASON M KIM
Urologist40.010.0$490,441$60,157$54,348Yes (X)
David Schulsinger
Urologist40.010.0$400,976$89,049$59,097Yes (X)
MASSIMILIANO SPALIVIERO
Urologist40.010.0$276,689$53,819$49,427Yes (X)
Steven Weissbart
Urologist40.010.0$120,784$50,668$31,214Yes (X)
FieldValueIRS element (for citing)
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Tot Reportable Comp Rltd Org$1,046,223TotReportableCompRltdOrgAmt
Total Other Compensation$469,375TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K13IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

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PersonNONEPersonNm
FieldValueIRS element (for citing)
Contractor AddressContractorAddress
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Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Business621111BusinessCd
Total Revenue Column$12,720,541TotalRevenueColumnAmt
Related Or Exempt Func Income$12,720,541RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$12,720,541TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

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Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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Royalties Revenue RoyaltiesRevenueGrp

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Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

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Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

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Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

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Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INTEREST (COMMON PAYMASTER, CLAIMS)Desc
Business900099BusinessCd
Total Revenue Column$11,960TotalRevenueColumnAmt
Exclusion$11,960ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$11,960OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
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Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

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Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

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Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

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Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,075,011TotalAmt
Program Services$1,021,260ProgramServicesAmt
Management And General$53,751ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

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Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,236,450TotalAmt
Program Services$3,236,450ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$366,181TotalAmt
Program Services$366,181ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$16,879TotalAmt
Program Services$16,879ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

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Total$177,233TotalAmt
Program Services$177,233ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

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Program Services$6,480,000ProgramServicesAmt
Management And General$1,520,000ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

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Advertising AdvertisingGrp

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Total$0TotalAmt

Office Expenses OfficeExpensesGrp

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Program Services$20,665ProgramServicesAmt

Information Technology InformationTechnologyGrp

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Royalties RoyaltiesGrp

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Total$0TotalAmt

Occupancy OccupancyGrp

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Total$2,100TotalAmt
Program Services$2,100ProgramServicesAmt

Travel TravelGrp

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Total$0TotalAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

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Conferences Meetings ConferencesMeetingsGrp

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Total$0TotalAmt

Interest InterestGrp

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Payments To Affiliates PaymentsToAffiliatesGrp

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Depreciation Depletion DepreciationDepletionGrp

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Insurance InsuranceGrp

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Other Expenses OtherExpensesGrp

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DescCORPORATION TAXDesc
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Total Functional Expenses TotalFunctionalExpensesGrp

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FieldValueIRS element (for citing)
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FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
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Other Changes In Net Assets$162,043OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

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Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
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Current Tax Year Minus3 Years$9,217,423CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,522,917CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,836,346CurrentTaxYearMinus1YearAmt
Current Tax Year$12,720,541CurrentTaxYearAmt
Total$52,454,047TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

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Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

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Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

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Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,156,820CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,217,423CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,522,917CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,836,346CurrentTaxYearMinus1YearAmt
Current Tax Year$12,720,541CurrentTaxYearAmt
Total$52,454,047TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,583,569CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,381,556CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,583,936CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,011,975CurrentTaxYearMinus1YearAmt
Current Tax Year$1,959,343CurrentTaxYearAmt
Total$8,520,379TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,583,569CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,381,556CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,583,936CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,011,975CurrentTaxYearMinus1YearAmt
Current Tax Year$1,959,343CurrentTaxYearAmt
Total$8,520,379TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$43,933,668PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,665CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,179CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,754CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,824CurrentTaxYearMinus1YearAmt
Current Tax Year$11,960CurrentTaxYearAmt
Total$35,382TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,665CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,179CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,754CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,824CurrentTaxYearMinus1YearAmt
Current Tax Year$11,960CurrentTaxYearAmt
Total$35,382TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,162,485CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,225,602CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,525,671CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,843,170CurrentTaxYearMinus1YearAmt
Current Tax Year$12,732,501CurrentTaxYearAmt
Total$52,489,429TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.83700PublicSupportCY509Pct
Public Support PY5090.83701PublicSupportPY509Pct
Investment Income CY0.00067InvestmentIncomeCYPct
Investment Income PY0.00053InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Wayne Waltzer
President & Director$477,883$255,547$277,526$0$2,393$0$37,181$37,837$2,070$14,016$797,053$307,400$0$0
Robert Wasnick
Secretary & Director$148,937$144,241$0$0$2,261$0$17,872$21,141$1,949$14,016$171,019$179,398$0$0
Sadar Ali Khan
Director$54,702$170,501$37,030$0$1,694$0$10,817$25,080$2,696$14,016$106,939$209,597$0$0
Frank Darras
Urologist$263,163$222,241$129,075$0$2,393$0$39,402$28,891$1,291$14,016$435,324$265,148$0$0
JASON M KIM
Urologist$321,540$60,157$166,508$0$2,393$0$39,402$0$930$14,016$530,773$74,173$0$0
David Schulsinger
Urologist$315,964$89,049$82,619$0$2,393$0$32,400$11,576$1,105$14,016$434,481$114,641$0$0
MASSIMILIANO SPALIVIERO
Urologist$274,296$53,819$0$2,393$0$32,400$2,422$589$14,016$309,678$70,257$0$0
Steven Weissbart
Urologist$119,405$50,668$0$0$1,379$0$14,329$2,280$589$14,016$135,702$66,964$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 7FormAndLineReferenceDesc
ExplanationTHE OFFICERS RECEIVED COMPENSATION OVER BASE SALARY INCLUDING THE BONUS DETERMINED AT THE ORGANIZATIONS DISCRETION OR BASED SPECIFICALLY ON BONUS PLANS SET BY THE ENTITY, DETERMINED AS REASONABLE. THIS BENEFIT IS SUBJECT TO THE GUIDELINES FOR NONFIXED PAYMENTS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, QUESTION 11BAN ELECTRONIC VERSION OF FORM 990 WAS PROVIDED TO THE OFFICERS AND DIRECTORS PRIOR TO FILING. MANAGEMENT PERFORMS A REVIEW of FORM 990 PRIOR TO FILING, ADDRESSING ANY QUESTIONS MADE BY THE GOVERNING BODY.
FORM 990, PART VI, QUESTION 12CTHE PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT THE UFPC'S INTEREST WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE UFPC OR MIGHT RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OF COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. COMPLIANCE WITH THIS POLICY IS MONITORED THROUGH INTERNAL PAYMENT POLICIES AND ANNUAL REPRESENTATIONS. THE REVIEWS, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: A. WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. B. WHETHER PARTNERSHIPS, JOINT VENTURES, AND ARRANGEMENTS WITH MANAGEMENT ORGANIZATIONS CONFORM TO THE UFPC'S WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE INVESTMENT OR PAYMENT FOR GOODS AND SERVICES, FURTHER EDUCATIONAL PURPOSES AND DO NOT RESULT IN INUREMENT, IMPERMISSIBLE PRIVATE BENEFIT OR IN AN EXCESS BENEFIT TRANSACTION. A VOTING MEMBER OF THE GOVERNING BOARD WHO HAS A COMPENSATION CONFLICT IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. IF THERE ARE VIOLATIONS TO THE POLICY, THE COMMITTEE OR GOVERNING BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION.
FORM 990, PART VI, QUESTIONS 15A & 15BBEGAN AT INCEPTION: EACH PHYSICIAN IS A MEMBER OF THE SCHOOL OF MEDICINE'S FACULTY AND A NEW YORK STATE EMPLOYEE PROVIDING SERVICES AT THE UNIVERSITY, AND REPORTS TO THE CHAIRMAN OF HIS/HER DEPARTMENT AND THE DEAN OF THE SCHOOL OF MEDICINE, WHO IN TURN REPORTS TO THE PRESIDENT OF THE UNIVERSITY. THE DEAN OF THE SCHOOL OF MEDICINE IS RESPONSIBLE FOR HIRING AND TERMINATING EACH PHYSICIAN, DETERMINING EACH PHYSICIAN'S COMPENSATION (WHICH IS SUBJECT TO THE LIMITATIONS IN ARTICLE XVI AS DESCRIBED BELOW), AND ALSO APPOINTS THE CHAIRPERSON OF THE SCHOOL OF MEDICINE'S DEPARTMENT OF UROLOGY, (I) WHO IS ONE OF THE DIRECTORS; AND (II) WHO IN TURN SELECTS ITS OTHER TWO DIRECTORS. CONSEQUENTLY, THE DIRECTORS MUST ACT IN A MANNER WHICH WILL NOT JEOPARDIZE THEIR EMPLOYMENT WITH THE MEDICAL SCHOOL AND THE UNIVERSITY IN ORDER TO REMAIN ON THE BOARD. AS A RESULT, NEW YORK STATE, THROUGH THE SUNY SYSTEM, THE UNIVERSITY, THE MEDICAL SCHOOL, AND CPMP (AS EXPLAINED BELOW) EXERCISES SUBSTANTIAL CONTROL OVER OPERATIONS, WHICH ARE ALSO SUBJECT TO ORIGINATING DOCUMENTS (I.E., CERTIFICATE OF REINCORPORATION AND BYLAWS), WHICH STATE THE PURPOSE AS FURTHERING THE UNIVERSITY'S EDUCATIONAL MISSION. ALL PHYSICIANS ENTER INTO EMPLOYMENT ARRANGEMENTS WITH THE UFPC. AS A RESULT, EACH PHYSICIAN RECEIVES COMPENSATION AND BENEFITS FROM THE UFPC AND THE STATE OF NEW YORK (BECAUSE SUCH PHYSICIAN IS ALSO A UNIVERSITY EMPLOYEE). THE DEAN OF THE SCHOOL OF MEDICINE DETERMINES EACH PHYSICIAN'S COMPENSATION, IN CONSULTATION WITH SUCH PHYSICIAN'S DEPARTMENTAL CHAIRPERSON. DOCUMENTATION REGARDING SUCH COMPENSATION DETERMINATION IS MAINTAINED BY THE DEAN'S OFFICE. EACH PHYSICIAN IS COMPENSATED BASED ON TRADITIONAL FACTORS SUCH AS TRAINING, EXPERIENCE, QUALIFICATIONS, AND GENERAL MARKET CONDITIONS. SUBJECT TO THE LIMITATIONS DESCRIBED BELOW, EMPLOYMENT AGREEMENTS WITH PHYSICIANS TYPICALLY ALLOW AN INDIVIDUAL PHYSICIAN TO RECEIVE NON-FIXED COMPENSATION, BASED ON AMOUNTS COLLECTED WHICH ARE ATTRIBUTABLE TO SUCH PHYSICIAN'S DIRECT PATIENT CARE SERVICES. THE ORGANIZATION GENERALLY DETERMINES A PHYSICIAN'S COMPENSATION TO EQUAL AN AMOUNT BETWEEN THE 50TH AND 75TH PERCENTILE OF COMPARABLE PHYSICIAN COMPENSATION, AS REPORTED IN THE ASSOCIATION OF AMERICAN MEDICAL COLLEGE'S (THE "AAMC'S") COMPENSATION DATA REFERENCE MATERIALS. EACH PHYSICIAN IS ALSO SUBJECT TO ARTICLE XVI, WHICH AT ALL TIMES GOVERNS SUCH PHYSICIAN'S COMPENSATION. UNDER THE TERMS OF ARTICLE XVI, THE MAXIMUM AMOUNT OF COMPENSATION PAYABLE TO ANY PHYSICIAN (INCLUDING COMPENSATION FROM ALL OTHER SOURCE EXCLUSIVE OF FRINGE BENEFITS) IS NOT TO EXCEED 250% OF THAT INDIVIDUAL'S MAXIMUM STATE BASIC ANNUAL SALARY FOR HIS/HER ACADEMIC RANK (THE "250% RULE"). IN SPECIAL CIRCUMSTANCES RELATING TO RECRUITMENT, THE UNIVERSITY PRESIDENT (OR HIS/HER DESIGNEE) MAY AUTHORIZE A PHYSICIAN TO RECEIVE GREATER THAN 250% OF THE MAXIMUM STATE BASIC ANNUAL SALARY FOR SUCH PHYSICIAN'S RANK, PROVIDED THAT SUCH COMPENSATION IS IN THE BEST INTEREST OF THE UNIVERSITY AND THE HOSPITAL. SUCH ADDITIONAL COMPENSATION SHALL NOT EXTEND BEYOND A TWO YEAR PERIOD. ALSO, WITH THE APPROVAL OF THE CHANCELLOR OF THE SUNY SYSTEM (OR HIS/HER DESIGNEE) THE MAXIMUM ALLOWABLE COMPENSATION PAYABLE TO A PHYSICIAN MAY EXCEED 275% OF SUCH INDIVIDUAL'S MAXIMUM STATE BASIC ANNUAL SALARY (E.G., IN THE CASE OF PHYSICIANS PROVIDING SERVICES IN DIFFICULT TO RETAIN SPECIALTIES). IN MAKING RECOMMENDATIONS WITH RESPECT TO SUCH EXCEPTIONS TO THE "250% RULE", THE PRESIDENT OF THE UNIVERSITY CONSIDERS THE COMPETITION FOR PHYSICIANS IN A PARTICULAR SPECIALTY AS INDICATED BY THE AAMC'S COMPENSATION DATA, AND OTHER REVENUE GENERATED BY THE PHYSICIAN'S CLINICAL ACTIVITIES. SUCH EXCEPTIONS, PURSUANT TO THE TERMS OF ARTICLE XVI, SHALL NOT EXCEED 5% OF THE TOTAL NUMBER OF PHYSICIANS ON A SYSTEM-WIDE BASIS. ALSO, SUBJECT TO THE TERMS OF ARTICLE XVI, A PORTION OF EACH PHYSICIAN'S COMPENSATION MAY BE USED TO PURCHASE A RETIREMENT BENEFIT FOR THE BENEFIT OF PHYSICIANS.
FORM 990, PART VI, QUESTION 19NO DOCUMENTS AVAILABLE TO THE PUBLIC.
FORM 990, PART VIITHE MISSION OF THE REPORTING ORGANIZATION IS TO SUPPORT THE EDUCATIONAL MISSION OF THE STATE UNIVERSITY OF NEW YORK SCHOOL OF MEDICINE AT STONY BROOK (THE "MEDICAL SCHOOL") BY PROVIDING CLINICAL INSTRUCTION TO AND SUPERVISION OF MEDICAL SCHOOL STUDENTS, INTERNS AND RESIDENTS AND, INCIDENT THERETO, RENDERING PROFESSIONAL SERVICES. EACH PHYSICIAN IS AN EMPLOYEE OF THE REPORTING ORGANIZATION AND A NEW YORK STATE EMPLOYEE PROVIDING SERVICES AS A MEMBER OF THE MEDICAL SCHOOL'S FACULTY. HOURS WORKED BY THE PHYSICIANS LISTED IN PART VII RELATE TO THE ENTIRE MISSION OF THE REPORTING ORGANIZATION WHICH INCLUDES SUPPORTING THE MISSION OF THE MEDICAL SCHOOL.
FORM 990, PART XI, LINE 9Cash transfer from SB Clinical Practice Management Plan, Inc. = $162,043

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (20 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
New York State
1 Commerce Plz 99 Washington AveAlbanyNY12231146013200GovernmentNY501(c)(1)N/ANAfalse
Stony Brook Anaesthesiology UFPC
PO Box 1554Stony BrookNY11790112553515HealthcareNY501(c)(3)10NYSfalse
Stony Brook Dermatology Associates UFPC
PO Box 1554Stony BrookNY11790113011790HealthcareNY501(c)(3)10NYSfalse
Stony Brook Clin Pract Mgmt Realty Corp
PO Box 1554Stony BrookNY11790113285712Rlty HoldingNY501(c)(25)N/ACPMPfalse
Stony Brook Surgical Holding Corp
PO Box 1554Stony BrookNY11790116434538Rlty HoldingNY501(c)(25)N/ACPMPfalse
SB CLINICAL PRACTICE MANAGEMENT PLAN INC
PO Box 1554Stony BrookNY11790461787308Mgmt ActivityNY501(c)(3)10NAfalse
Stony Brook Emergency Physicians UFPC
PO Box 1554Stony BrookNY11790113066770HealthcareNY501(c)(3)10NYSfalse
SB Family and Preventive Medicine UFPC
PO Box 1554Stony BrookNY11790112552321HealthcareNY501(c)(3)10NYSfalse
Stony Brook Internists UFPC
PO Box 1554Stony BrookNY11790112558775HealthcareNY501(c)(3)10NYSfalse
New York Spine and Brain Surgery UFPC
PO Box 1554Stony BrookNY11790112645930HealthcareNY501(c)(3)10NYSfalse
Neurology Assoc of Stony Brook UFPC
PO Box 1554Stony BrookNY11790112587430HealthcareNY501(c)(3)10NYSfalse
Univ Assoc in Obst & Gynecology UFPC
PO Box 1554Stony BrookNY11790112569522HealthcareNY501(c)(3)10NYSfalse
Stony Brook Pathologists UFPC
PO Box 1554Stony BrookNY11790112647243HealthcareNY501(c)(3)10NYSfalse
Stony Brook Ophthalmology UFPC
PO Box 1554Stony BrookNY11790112658697HealthcareNY501(c)(3)10NYSfalse
Stony Brook Orthopaedic Associates UFPC
PO Box 1554Stony BrookNY11790112593061HealthcareNY501(c)(3)10NYSfalse
Stony Brook Children's Service UFPC
PO Box 1554Stony BrookNY11790112571524HealthcareNY501(c)(3)10NYSfalse
Stony Brook Psychiatric Associates UFPC
PO Box 1554Stony BrookNY11790112590096HealthcareNY501(c)(3)10NYSfalse
Stony Brook Radiation Oncology UFPC
PO Box 1554Stony BrookNY11790112664726HealthcareNY501(c)(3)10NYSfalse
Stony Brook Radiology UFPC
PO Box 1554Stony BrookNY11790112548304HealthcareNY501(c)(3)10NYSfalse
Stony Brook Surgical Associates UFPC
PO Box 1554Stony BrookNY11790112552333HealthcareNY501(c)(3)10NYSfalse

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SB HLTHCARE IPA LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1554AddressLine1Txt
CitySTNY BRKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11790ZIPCd
FieldValueIRS element (for citing)
EIN113499101EIN
Primary ActivitiesHealthcarePrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CPMPBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income$0ShareOfTotalIncomeAmt
Share Of EOY Assets$0ShareOfEOYAssetsAmt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
UBI Code V$0UBICodeVAmt
General Or Managing PartnerfalseGeneralOrManagingPartnerInd
Ownership0.00000OwnershipPct

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1NICOLLS INDEMNITY SOLUTIONS SPBusinessNameLine1Txt

Foreign Address ForeignAddress

FieldValueIRS element (for citing)
Address Line127 HOSPITAL RDAddressLine1Txt
CityCAYMAN CORP CTCityNm
CountryCJCountryCd
Foreign PostalKYI-900ForeignPostalCd
FieldValueIRS element (for citing)
Primary ActivitiesSELF-INSURANCEPrimaryActivitiesTxt
Legal Domicile Foreign CountryCJLegalDomicileForeignCountryCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NABusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeC CORPEntityTypeTxt
Share Of Total Income$0ShareOfTotalIncomeAmt
Share Of EOY Assets$0ShareOfEOYAssetsAmt
Ownership0.00000OwnershipPct
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgfalseRentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (true)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (true)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (true)TransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1State of New YorkBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeLTransactionTypeTxt
Involved$127,325InvolvedAmt
Method Of Amount DeterminationFMVMethodOfAmountDeterminationTxt