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WEST ISLIP MEDICAL CARE, P.C.

Company Details

Name: WEST ISLIP MEDICAL CARE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 01 Apr 1994 (31 years ago)
Entity Number: 1808745
County: Suffolk
Place of Formation: New York
Address: 510 MONTAUK HWY, STE D, WEST ISLIP, NY, United States, 11795
Address ZIP Code: 11795

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
WEST ISLIP MEDICAL CARE, P.C. RETIREMENT TRUST (PS) 2023 113204253 2024-09-06 WEST ISLIP MEDICAL CARE, P.C. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-04-01
Business code 621111
Sponsor’s telephone number 6315877474
Plan sponsor’s address 510 MONTAUK HIGHWAY, SUITE D, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2024-09-06
Name of individual signing CHRISTOPHER PIASZCZYK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-09-06
Name of individual signing CHRISTOPHER PIASZCZYK
Valid signature Filed with authorized/valid electronic signature
WEST ISLIP MEDICAL CARE, P.C. RETIREMENT TRUST (PS) 2022 113204253 2023-07-10 WEST ISLIP MEDICAL CARE, P.C. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-04-01
Business code 621111
Sponsor’s telephone number 6315877474
Plan sponsor’s address 510 MONTAUK HIGHWAY, SUITE D, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2023-07-10
Name of individual signing CHRISTOPHER PIASZCZYK
Role Employer/plan sponsor
Date 2023-07-10
Name of individual signing CHRISTOPHER PIASZCZYK
WEST ISLIP MEDICAL CARE, P.C. RETIREMENT TRUST (PS) 2021 113204253 2022-09-26 WEST ISLIP MEDICAL CARE, P.C. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-04-01
Business code 621111
Sponsor’s telephone number 6315877474
Plan sponsor’s address 510 MONTAUK HIGHWAY, SUITE D, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2022-09-26
Name of individual signing CHRISTOPHER PIASZCZYK
Role Employer/plan sponsor
Date 2022-09-26
Name of individual signing CHRISTOPHER PIASZCZYK
WEST ISLIP MEDICAL CARE, P.C. RETIREMENT TRUST (PS) 2020 113204253 2022-05-06 WEST ISLIP MEDICAL CARE, P.C. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-04-01
Business code 621111
Sponsor’s telephone number 6315877474
Plan sponsor’s address 510 MONTAUK HIGHWAY, SUITE D, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2022-05-06
Name of individual signing CHRISTOPHER PIASZCZYK
Role Employer/plan sponsor
Date 2022-05-06
Name of individual signing CHRISTOPHER PIASZCZYK
WEST ISLIP MEDICAL CARE, P.C. RETIREMENT TRUST (PS) 2020 113204253 2021-08-24 WEST ISLIP MEDICAL CARE, P.C. 4
Three-digit plan number (PN) 002
Effective date of plan 1994-04-01
Business code 621111
Sponsor’s telephone number 6315877474
Plan sponsor’s address 510 MONTAUK HIGHWAY, SUITE D, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2021-08-24
Name of individual signing CHRISTOPHER PIASZCZYK
Role Employer/plan sponsor
Date 2021-08-24
Name of individual signing CHRISTOPHER PIASZCZYK
WEST ISLIP MEDICAL CARE, P.C. RETIREMENT TRUST (PS) 2019 113204253 2020-09-14 WEST ISLIP MEDICAL CARE, P.C. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-04-01
Business code 621111
Sponsor’s telephone number 6315877474
Plan sponsor’s address 510 MONTAUK HIGHWAY, SUITE D, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2020-09-14
Name of individual signing CHRISTOPHER PIASZCZYK
Role Employer/plan sponsor
Date 2020-09-14
Name of individual signing CHRISTOPHER PIASZCZYK
WEST ISLIP MEDICAL CARE, P.C. RETIREMENT TRUST (PS) 2018 113204253 2019-09-10 WEST ISLIP MEDICAL CARE, P.C. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-04-01
Business code 621111
Sponsor’s telephone number 6315877474
Plan sponsor’s address 510 MONTAUK HIGHWAY, SUITE D, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2019-09-10
Name of individual signing CHRISTOPHER PIASZCZYK
Role Employer/plan sponsor
Date 2019-09-10
Name of individual signing CHRISTOPHER PIASZCZYK
WEST ISLIP MEDICAL CARE, P.C. RETIREMENT TRUST (PS) 2017 113204253 2018-07-23 WEST ISLIP MEDICAL CARE, P.C. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-04-01
Business code 621111
Sponsor’s telephone number 6315877474
Plan sponsor’s address 510 MONTAUK HIGHWAY, SUITE D, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2018-07-23
Name of individual signing CHRIS PIASZCZYK
Role Employer/plan sponsor
Date 2018-07-23
Name of individual signing CHRIS PIASZCZYK
WEST ISLIP MEDICAL CARE, P.C. RETIREMENT TRUST (PS) 2016 113204253 2017-06-26 WEST ISLIP MEDICAL CARE, P.C. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-04-01
Business code 621111
Sponsor’s telephone number 6315877474
Plan sponsor’s address 510 MONTAUK HIGHWAY, SUITE D, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2017-06-26
Name of individual signing CHRIS PIASZCZYK
Role Employer/plan sponsor
Date 2017-06-26
Name of individual signing CHRIS PIASZCZYK
WEST ISLIP MEDICAL CARE, P.C. RETIREMENT TRUST (PS) 2015 113204253 2016-06-28 WEST ISLIP MEDICAL CARE, P.C. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1994-04-01
Business code 621111
Sponsor’s telephone number 6315877474
Plan sponsor’s address 510 MONTAUK HIGHWAY, SUITE D, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2016-06-28
Name of individual signing CHRIS PIASZCZUL
Role Employer/plan sponsor
Date 2016-06-28
Name of individual signing CHRIS PIASZCZUL

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 510 MONTAUK HWY, STE D, WEST ISLIP, NY, United States, 11795

Chief Executive Officer

Name Role Address
ANNA GORSKI, MD Chief Executive Officer 510 MONTAUK HWY, STE D, WEST ISLIP, NY, United States, 11795

History

Start date End date Type Value
1996-05-23 2014-06-27 Address 510 MONTAUK HIGHWAY, STE. D, WEST ISLIP, NY, 11795, USA (Type of address: Chief Executive Officer)
1996-05-23 2014-06-27 Address 510 MONTAUK HIGHWAY, STE. D, WEST ISLIP, NY, 11795, USA (Type of address: Principal Executive Office)
1996-05-23 2014-06-27 Address 510 MONTAUK HIGHWAY, STE. D, WEST ISLIP, NY, 11795, USA (Type of address: Service of Process)
1994-04-01 1996-05-23 Address 510 W. MONTAUK HIGHWAY, W. ISLIP, NY, 11795, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
140627002166 2014-06-27 BIENNIAL STATEMENT 2014-04-01
100504002467 2010-05-04 BIENNIAL STATEMENT 2010-04-01
080429002307 2008-04-29 BIENNIAL STATEMENT 2008-04-01
060412002097 2006-04-12 BIENNIAL STATEMENT 2006-04-01
040413002197 2004-04-13 BIENNIAL STATEMENT 2004-04-01
020415002387 2002-04-15 BIENNIAL STATEMENT 2002-04-01
000524003021 2000-05-24 BIENNIAL STATEMENT 2000-04-01
980417002595 1998-04-17 BIENNIAL STATEMENT 1998-04-01
960523002238 1996-05-23 BIENNIAL STATEMENT 1996-04-01
940401000430 1994-04-01 CERTIFICATE OF INCORPORATION 1994-04-01

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Related by address

No related companies by address

Date of last update: 13 Nov 2024

Sources: New York Secretary of State

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