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  5. CENTRAL BROOKLYN MEDICAL GROUP, P.C.

CENTRAL BROOKLYN MEDICAL GROUP, P.C.

Company Details

Name: CENTRAL BROOKLYN MEDICAL GROUP, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 12 Apr 1989 (36 years ago)
Date of dissolution: 31 Dec 2016
Entity Number: 1343431
ZIP code: 10001
County: New York
Place of Formation: New York
Principal Address: ADVANTAGECARE PHYSICIANS, P.C., 55 WATER STREET, NEW YORK, NY, United States, 10041
Address: 441 NINTH AVENUE, 8TH FLOOR, NEW YORK, NY, United States, 10001

Shares Details

Shares issued 400

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THE SAVINGS PLAN FOR EMPLOYEES OF CENTRAL BROOKLYN MEDICAL GROUP, P.C. 2012 112937992 2013-10-15 CENTRAL BROOKLYN MEDICAL GROUP, P.C. 478
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1985-01-01
Business code 621111
Sponsor’s telephone number 7184228200
Plan sponsor’s mailing address 1 METROTECH CENTER NORTH, 9TH FLOOR, BROOKLYN, NY, 11201
Plan sponsor’s address 1 METROTECH CENTER NORTH, 9TH FLOOR, BROOKLYN, NY, 11201

Plan administrator’s name and address
Administrator’s EIN 112937992
Plan administrator’s name CENTRAL BROOKLYN MEDICAL GROUP, P.C.
Plan administrator’s address 1 METROTECH CENTER NORTH, 9TH FLOOR, BROOKLYN, NY, 11201
Administrator’s telephone number 7184228200

Number of participants as of the end of the plan year
Active participants 286
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 174
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 427
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2013-10-15
Name of individual signing MARTHA VORMITTAG
Valid signature Filed with authorized/valid electronic signature
THE SAVINGS PLAN FOR EMPLOYEES OF CENTRAL BROOKLYN MEDICAL GROUP, P.C. 2012 112937992 2013-10-14 CENTRAL BROOKLYN MEDICAL GROUP, P.C. 478
Three-digit plan number (PN) 004
Effective date of plan 1985-01-01
Business code 621111
Sponsor’s telephone number 7184228200
Plan sponsor’s mailing address 1 METROTECH CENTER NORTH, 9TH FLOOR, BROOKLYN, NY, 11201
Plan sponsor’s address 1 METROTECH CENTER NORTH, 9TH FLOOR, BROOKLYN, NY, 11201

Plan administrator’s name and address
Administrator’s EIN 112937992
Plan administrator’s name CENTRAL BROOKLYN MEDICAL GROUP, P.C.
Plan administrator’s address 1 METROTECH CENTER NORTH, 9TH FLOOR, BROOKLYN, NY, 11201
Administrator’s telephone number 7184228200

Number of participants as of the end of the plan year
Active participants 286
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 174
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 427
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing MARTHA VORMITTAG
Valid signature Filed with authorized/valid electronic signature
THE SAVINGS PLAN FOR EMPLOYEES OF CENTRAL BROOKLYN MEDICAL GROUP, P.C. 2011 112937992 2012-10-10 CENTRAL BROOKLYN MEDICAL GROUP, P.C. 486
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1985-01-01
Business code 621111
Sponsor’s telephone number 7184228055
Plan sponsor’s mailing address 1 METROTECH CENTER NORTH, 9TH FLOOR, BROOKLYN, NY, 11201
Plan sponsor’s address 1 METROTECH CENTER NORTH, 9TH FLOOR, BROOKLYN, NY, 11201

Plan administrator’s name and address
Administrator’s EIN 112937992
Plan administrator’s name CENTRAL BROOKLYN MEDICAL GROUP, P.C.
Plan administrator’s address 1 METROTECH CENTER NORTH, 9TH FLOOR, BROOKLYN, NY, 11201
Administrator’s telephone number 7184228055

Number of participants as of the end of the plan year
Active participants 308
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 170
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 404
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-10-10
Name of individual signing MARTHA VORMITTAG
Valid signature Filed with authorized/valid electronic signature
THE SAVINGS PLAN FOR EMPLOYEES OF CENTRAL BROOKLYN MEDICAL GROUP, P.C. 2010 112937992 2012-01-03 CENTRAL BROOKLYN MEDICAL GROUP, P.C. 499
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1985-01-01
Business code 621111
Sponsor’s telephone number 7184228060
Plan sponsor’s mailing address 1 METROTECH CENTER NORTH, 9TH FLOOR, BROOKLYN, NY, 11201
Plan sponsor’s address 1 METROTECH CENTER NORTH, 9TH FLOOR, BROOKLYN, NY, 11201

Plan administrator’s name and address
Administrator’s EIN 112937992
Plan administrator’s name CENTRAL BROOKLYN MEDICAL GROUP, P.C.
Plan administrator’s address 1 METROTECH CENTER NORTH, 9TH FLOOR, BROOKLYN, NY, 11201
Administrator’s telephone number 7184228060

Number of participants as of the end of the plan year
Active participants 354
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 132
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 388
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-12-28
Name of individual signing DENNIS PRICE
Valid signature Filed with authorized/valid electronic signature
THE SAVINGS PLAN FOR EMPLOYEES OF CENTRAL BROOKLYN MEDICAL GROUP, P.C. 2010 112937992 2011-10-19 CENTRAL BROOKLYN MEDICAL GROUP, P.C. 499
Three-digit plan number (PN) 004
Effective date of plan 1985-01-01
Business code 621111
Sponsor’s telephone number 7184228060
Plan sponsor’s mailing address 1 METROTECH CENTER NORTH, 9TH FLOOR, BROOKLYN, NY, 11201
Plan sponsor’s address 1 METROTECH CENTER NORTH, 9TH FLOOR, BROOKLYN, NY, 11201

Plan administrator’s name and address
Administrator’s EIN 112937992
Plan administrator’s name CENTRAL BROOKLYN MEDICAL GROUP, P.C.
Plan administrator’s address 1 METROTECH CENTER NORTH, 9TH FLOOR, BROOKLYN, NY, 11201
Administrator’s telephone number 7184228060

Number of participants as of the end of the plan year
Active participants 354
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 132
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 388
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-10-19
Name of individual signing DENNIS PRICE
Valid signature Filed with authorized/valid electronic signature
THE SAVINGS PLAN FOR EMPLOYEES OF CENTRAL BROOKLYN MEDICAL GROUP, P.C. 2009 112937992 2011-04-21 CENTRAL BROOKLYN MEDICAL GROUP, P.C. 513
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1985-01-01
Business code 621111
Sponsor’s telephone number 7184228060
Plan sponsor’s mailing address 32 COURT STREET, SUITE 1900, BROOKLYN, NY, 11201
Plan sponsor’s address 32 COURT STREET, SUITE 1900, BROOKLYN, NY, 11201

Plan administrator’s name and address
Administrator’s EIN 112937992
Plan administrator’s name CENTRAL BROOKLYN MEDICAL GROUP, P.C.
Plan administrator’s address 32 COURT STREET, SUITE 1900, BROOKLYN, NY, 11201
Administrator’s telephone number 7184228060

Number of participants as of the end of the plan year
Active participants 378
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 121
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 372
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-04-21
Name of individual signing JOHN HUGHES
Valid signature Filed with authorized/valid electronic signature
THE SAVINGS PLAN FOR EMPLOYEES OF CENTRAL BROOKLYN MEDICAL GROUP, P.C. 2009 112937992 2010-10-15 CENTRAL BROOKLYN MEDICAL GROUP, P.C. 513
Three-digit plan number (PN) 004
Effective date of plan 1985-01-01
Business code 621111
Sponsor’s telephone number 7184228060
Plan sponsor’s mailing address 32 COURT STREET, SUITE 1900, BROOKLYN, NY, 11201
Plan sponsor’s address 32 COURT STREET, SUITE 1900, BROOKLYN, NY, 11201

Plan administrator’s name and address
Administrator’s EIN 112937992
Plan administrator’s name CENTRAL BROOKLYN MEDICAL GROUP, P.C.
Plan administrator’s address 32 COURT STREET, SUITE 1900, BROOKLYN, NY, 11201
Administrator’s telephone number 7184228060

Number of participants as of the end of the plan year
Active participants 378
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 121
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 372
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-10-15
Name of individual signing JOHN HUGHES
Valid signature Filed with authorized/valid electronic signature
CENTRAL BROOKLYN MEDICAL GROUP, P.C. RETIREMENT PLAN AND TRUST 2009 112937992 2010-07-30 CENTRAL BROOKLYN MEDICAL GROUP, P.C. No data
File View Page
Three-digit plan number (PN) 003
Plan sponsor’s mailing address 32 COURT STREET 19TH FLOOR, BROOKLYN, NY, 11201
Plan sponsor’s address 32 COURT STREET 19TH FLOOR, BROOKLYN, NY, 11201

Plan administrator’s name and address
Administrator’s EIN 112937992
Plan administrator’s name CENTRAL BROOKLYN MEDICAL GROUP, P.C.
Plan administrator’s address 32 COURT STREET 19TH FLOOR, BROOKLYN, NY, 11201
THE SAVINGS PLAN FOR EMPLOYEES OF CENTRAL BROOKLYN MEDICAL GROUP, P.C. 2009 112937992 2010-07-30 CENTRAL BROOKLYN MEDICAL GROUP, P.C. No data
File View Page
Three-digit plan number (PN) 004
Plan sponsor’s mailing address 32 COURT STREET, 19TH FLOOR, BROOKLYN, NY, 11201
Plan sponsor’s address 32 COURT STREET, 19TH FLOOR, BROOKLYN, NY, 11201

Plan administrator’s name and address
Administrator’s EIN 112937992
Plan administrator’s name CENTRAL BROOKLYN MEDICAL GROUP, P.C.
Plan administrator’s address 32 COURT STREET, 19TH FLOOR, BROOKLYN, NY, 11201

Chief Executive Officer

Name Role Address
NAVARRA RODRIGUEZ, M.D. Chief Executive Officer 55 WATER STREET, NEW YORK, NY, United States, 10041

DOS Process Agent

Name Role Address
CENTRAL BROOKLYN MEDICAL GROUP, P.C. DOS Process Agent 441 NINTH AVENUE, 8TH FLOOR, NEW YORK, NY, United States, 10001

History

Start date End date Type Value
2015-07-17 2016-10-05 Address 441 NINTH AVENUE, 8TH FLOOR, NEW YORK, NY, 10001, USA (Type of address: Principal Executive Office)
2015-07-17 2016-10-05 Address 441 NINTH AVENUE, 8TH FLOOR, NEW YORK, NY, 10001, USA (Type of address: Chief Executive Officer)
2015-01-12 2015-07-17 Address 55 WATER ST, NEW YORK, NY, 10041, USA (Type of address: Chief Executive Officer)
2014-12-05 2015-07-17 Address 55 WATER ST, NEW YORK, NY, 10041, USA (Type of address: Principal Executive Office)
2014-12-05 2015-07-17 Address 55 WATER ST, NEW YORK, NY, 10041, USA (Type of address: Service of Process)
2014-12-05 2015-01-12 Address 55 WATER ST, NEW YORK, NY, 10041, USA (Type of address: Chief Executive Officer)
2013-08-13 2014-12-05 Address C/O EMBLEMHEALTH, 441 NINTH AVENUE, NEW YORK, NY, 10001, USA (Type of address: Service of Process)
2009-05-05 2014-12-05 Address 32 COURT ST, STE 1900, BROOKLYN, NY, 11201, USA (Type of address: Chief Executive Officer)
2007-05-01 2014-12-05 Address 32 COURT ST, STE 1900, BROOKLYN, NY, 11201, USA (Type of address: Principal Executive Office)
2007-05-01 2009-05-05 Address 32 COURT ST, STE 1900, BROOKLYN, NY, 11201, USA (Type of address: Chief Executive Officer)

Filings

Filing Number Date Filed Type Effective Date
161216000136 2016-12-16 CERTIFICATE OF MERGER 2016-12-31
161005002044 2016-10-05 AMENDMENT TO BIENNIAL STATEMENT 2015-04-01
150717006109 2015-07-17 BIENNIAL STATEMENT 2015-04-01
150112002022 2015-01-12 AMENDMENT TO BIENNIAL STATEMENT 2013-04-01
141205002022 2014-12-05 BIENNIAL STATEMENT 2013-04-01
130813000305 2013-08-13 CERTIFICATE OF AMENDMENT 2013-08-13
130221000551 2013-02-21 CERTIFICATE OF AMENDMENT 2013-02-21
090505002558 2009-05-05 BIENNIAL STATEMENT 2009-04-01
070501003322 2007-05-01 BIENNIAL STATEMENT 2007-04-01
030414002524 2003-04-14 BIENNIAL STATEMENT 2003-04-01

Related by officers

NAVARRA RODRIGUEZ, M.D.

ADVANTAGECARE PHYSICIANS, P.C. LHHN MEDICAL, P.C. STATEN ISLAND PHYSICIAN PRACTICE, P.C. QUEENS-LONG ISLAND MEDICAL GROUP, P.C. SIUC MEDICAL, P.C.

Related by address

ADVANTAGECARE PHYSICIANS, P.C., 55 WATER STREET, NEW YORK, NY, United States, 10041

QUEENS-LONG ISLAND MEDICAL GROUP, P.C.

Date of last update: 14 Nov 2024

Sources: New York Secretary of State

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