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MITCHELL J. MANDEL, M.D. P.C.

Company Details

Name: MITCHELL J. MANDEL, M.D. P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 10 Oct 1995 (29 years ago)
Entity Number: 1963356
ZIP code: 11946
County: New York
Place of Formation: New York
Address: 19 Lighthouse Road, Hampton Bays, NY, United States, 11946
Principal Address: 1 POLO DRIVE, OLD WESTBURY, NY, United States, 11568

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
MITCHELL J. MANDEL, M.D., P.C. 401(K) PLAN 2023 133842292 2024-05-07 MITCHELL J. MANDEL, M.D., P.C. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 2125709595
Plan sponsor’s address 116 E 68TH ST, 1C, NEW YORK, NY, 10065

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2024-05-07
Name of individual signing QIAN LIU
MITCHELL J. MANDEL, M.D., P.C. 401(K) PLAN 2022 133842292 2023-05-26 MITCHELL J. MANDEL, M.D., P.C. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 2125709595
Plan sponsor’s address 116 E 68TH ST, 1C, NEW YORK, NY, 10065

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2023-05-26
Name of individual signing CHRISTINE RIMER
MITCHELL J. MANDEL, M.D., P.C. 401(K) PLAN 2021 133842292 2022-05-27 MITCHELL J. MANDEL, M.D., P.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 2125709595
Plan sponsor’s address 116 E 68TH ST, 1C, NEW YORK, NY, 10065

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2022-05-27
Name of individual signing CHRISTINE RIMER
MITCHELL J. MANDEL, M.D., P.C. 401(K) PLAN 2020 133842292 2021-09-12 MITCHELL J. MANDEL, M.D., P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 2125709595
Plan sponsor’s address 116 E 68TH ST, 1C, NEW YORK, NY, 10065

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2021-09-12
Name of individual signing CAROL HO
MITCHELL J. MANDEL, M.D., P.C. 401(K) PLAN 2019 133842292 2020-08-25 MITCHELL J. MANDEL, M.D., P.C. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 2125709595
Plan sponsor’s address 116 E 68TH ST, 1C, NEW YORK, NY, 10065

Plan administrator’s name and address

Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 3050 S DELAWARE ST, #202, SAN MATEO, CA, 94403
Administrator’s telephone number 8882283491

Signature of

Role Plan administrator
Date 2020-08-25
Name of individual signing CAROL HO

Chief Executive Officer

Name Role Address
MITCHELL J. MANDEL Chief Executive Officer 19 LIGHTHOUSE ROAD, HAMPTON BAYS, NY, United States, 11946

DOS Process Agent

Name Role Address
MITCHELL MANDEL DOS Process Agent 19 Lighthouse Road, Hampton Bays, NY, United States, 11946

History

Start date End date Type Value
1999-11-18 2011-11-03 Address #1 POLO DRIVE, OLD WESTBURY, NY, 11568, 1039, USA (Type of address: Chief Executive Officer)
1999-11-18 2011-11-03 Address #1 POLO DRIVE, OLD WESTBURY, NY, 11568, 1039, USA (Type of address: Principal Executive Office)
1997-10-20 1999-11-18 Address 36 WHITNEY LANE, BROOKVILLE, NY, 11545, USA (Type of address: Chief Executive Officer)
1997-10-20 1999-11-18 Address 36 WHITNEY LANE, BROOKVILLE, NY, 11545, USA (Type of address: Principal Executive Office)
1995-10-10 2021-07-20 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
1995-10-10 2001-10-01 Address 47 EAST 68TH STREET, NEW YORK, NY, 10021, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
210714003273 2021-07-14 BIENNIAL STATEMENT 2021-07-14
141219006574 2014-12-19 BIENNIAL STATEMENT 2013-10-01
111103002980 2011-11-03 BIENNIAL STATEMENT 2011-10-01
091007002958 2009-10-07 BIENNIAL STATEMENT 2009-10-01
071108002536 2007-11-08 BIENNIAL STATEMENT 2007-10-01
051202002420 2005-12-02 BIENNIAL STATEMENT 2005-10-01
031015002434 2003-10-15 BIENNIAL STATEMENT 2003-10-01
011001002199 2001-10-01 BIENNIAL STATEMENT 2001-10-01
991118002290 1999-11-18 BIENNIAL STATEMENT 1999-10-01
971020002137 1997-10-20 BIENNIAL STATEMENT 1997-10-01

Date of last update: 13 Nov 2024

Sources: New York Secretary of State