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NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C.

Company Details

Name: NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 26 Aug 1993 (31 years ago)
Entity Number: 1752427
County: Nassau
Place of Formation: New York
Address: 170 OLD COUNTRY ROAD, MINEOLA, NY, United States, 11501
Address ZIP Code: 11501
Principal Address: 1000 NORTHERN BLVD, STE 230, GREAT NECK, NY, United States, 11021
Principal Address ZIP Code: 11021

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 401K PLAN 2023 113305781 2024-10-14 NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 20
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5166274433
Plan sponsor’s address 1000 NORTHERN BLVD., SUITE 230, GREAT NECK, NY, 11021

Signature of
Role Plan administrator
Date 2024-10-14
Name of individual signing DAVID EDELSON
Valid signature Filed with authorized/valid electronic signature
NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 401K PLAN 2022 113305781 2023-08-11 NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 22
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5166274433
Plan sponsor’s address 1000 NORTHERN BLVD., SUITE 230, GREAT NECK, NY, 11021

Signature of
Role Plan administrator
Date 2023-08-11
Name of individual signing DAVID EDELSON
Role Employer/plan sponsor
Date 2023-08-11
Name of individual signing DAVID EDELSON
NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 401K PLAN 2022 113305781 2023-07-26 NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 22
Three-digit plan number (PN) 003
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5166274433
Plan sponsor’s address 1000 NORTHERN BLVD., SUITE 230, GREAT NECK, NY, 11021

Signature of
Role Plan administrator
Date 2023-07-26
Name of individual signing DAVID EDELSON
NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 401K PLAN 2021 113305781 2022-07-11 NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 24
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5166274433
Plan sponsor’s address 1000 NORTHERN BLVD., SUITE 230, GREAT NECK, NY, 11021

Signature of
Role Plan administrator
Date 2022-07-08
Name of individual signing DAVID EDELSON
Role Employer/plan sponsor
Date 2022-07-08
Name of individual signing DAVID EDELSON
NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 401K PLAN 2020 113305781 2021-02-17 NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 24
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5166274433
Plan sponsor’s address 1000 NORTHERN BLVD., SUITE 230, GREAT NECK, NY, 11021

Signature of
Role Plan administrator
Date 2021-02-17
Name of individual signing DAVID EDELSON
Role Employer/plan sponsor
Date 2021-02-17
Name of individual signing DAVID EDELSON
NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 401K PLAN 2019 113305781 2020-03-09 NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 25
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5166274433
Plan sponsor’s address 1000 NORTHERN BLVD., SUITE 230, GREAT NECK, NY, 11021

Signature of
Role Plan administrator
Date 2020-03-06
Name of individual signing DAVID EDELSON
NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 401K PLAN 2018 113305781 2019-03-04 NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 26
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5166274433
Plan sponsor’s address 1000 NORTHERN BLVD., SUITE 230, GREAT NECK, NY, 11021

Signature of
Role Plan administrator
Date 2019-02-22
Name of individual signing DAVID EDELSON
Role Employer/plan sponsor
Date 2019-02-22
Name of individual signing DAVID EDELSON
NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 401K PLAN 2017 113305781 2018-09-04 NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 30
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5166274433
Plan sponsor’s address 1000 NORTHERN BLVD., SUITE 230, GREAT NECK, NY, 11021

Signature of
Role Plan administrator
Date 2018-08-31
Name of individual signing DAVID EDELSON
NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 401K PLAN 2016 113305781 2017-02-15 NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 25
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5166274433
Plan sponsor’s address 1000 NORTHERN BLVD., SUITE 230, GREAT NECK, NY, 11021

Signature of
Role Plan administrator
Date 2017-02-05
Name of individual signing DAVID EDELSON
NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 401K PLAN 2015 113305781 2016-05-23 NORTH SHORE PRIMARY CARE MEDICAL ASSOCIATES, P.C. 27
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 5166274433
Plan sponsor’s address 1000 NORTHERN BLVD., SUITE 230, GREAT NECK, NY, 11021

Signature of
Role Plan administrator
Date 2016-05-21
Name of individual signing DAVID EDELSON

DOS Process Agent

Name Role Address
MELVYN B. RUSKIN, ESQ., RUSKIN, MOSCOU, EVANS & FALTISCHEK PC DOS Process Agent 170 OLD COUNTRY ROAD, MINEOLA, NY, United States, 11501

Chief Executive Officer

Name Role Address
DR DAVID EDELSON Chief Executive Officer 1000 NORTHERN BLVD, GREAT NECK, NY, United States, 11021

History

Start date End date Type Value
2001-08-13 2011-08-10 Address 1165 NORTHERN BLVD, STE 300, MANHASSET, NY, 11030, USA (Type of address: Chief Executive Officer)
2001-08-13 2011-08-10 Address 1165 NORTHERN BLVD, STE 300, MANHASSET, NY, 11030, USA (Type of address: Principal Executive Office)
1998-02-23 2001-08-13 Address 833 NORTHERN BLVD, STE 120, GREAT NECK, NY, 11021, USA (Type of address: Chief Executive Officer)
1998-02-23 2001-08-13 Address 833 NORTHERN BLVD, STE 120, GREAT NECK, NY, 11021, USA (Type of address: Principal Executive Office)

Filings

Filing Number Date Filed Type Effective Date
110810002129 2011-08-10 BIENNIAL STATEMENT 2011-08-01
090729002417 2009-07-29 BIENNIAL STATEMENT 2009-08-01
070919002171 2007-09-19 BIENNIAL STATEMENT 2007-08-01
051109002814 2005-11-09 BIENNIAL STATEMENT 2005-08-01
030812002196 2003-08-12 BIENNIAL STATEMENT 2003-08-01
010813002512 2001-08-13 BIENNIAL STATEMENT 2001-08-01
990820002469 1999-08-20 BIENNIAL STATEMENT 1999-08-01
980223002297 1998-02-23 BIENNIAL STATEMENT 1997-08-01
971230000696 1997-12-30 CERTIFICATE OF AMENDMENT 1997-12-30
930826000246 1993-08-26 CERTIFICATE OF INCORPORATION 1993-08-26

Related by officers

MELVYN B. RUSKIN, ESQ., RUSKIN, MOSCOU, EVANS & FALTISCHEK PC

BAY PAIN MANAGEMENT MEDICAL SERVICES, P.C.

Related by address

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1000 NORTHERN BLVD, STE 230, GREAT NECK, NY, United States, 11021

NORTH SHORE SLEEP MEDICINE, P.C.

Date of last update: 13 Nov 2024

Sources: New York Secretary of State

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