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PREVENTIVE MEDICINE ASSOCIATES, PLLC

Company Details

Name: PREVENTIVE MEDICINE ASSOCIATES, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 06 Nov 1995 (29 years ago) (Companies founded in November 1995)
Entity Number: 1971016
ZIP code: 13031 (Companies in Onondaga, 13031)
County: Onondaga
Place of Formation: New York
Address: 5415 WEST GENESEE ST, STE 301, CAMILLUS, NY, United States, 13031

Contact Details

Phone +1 315-487-8109

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PREVENTIVE MEDICINE ASSOCIATES, PLLC CASH BALANCE PENSION PLAN 2023 161490162 2024-10-07 PREVENTIVE MEDICINE ASSOCIATES, PLLC 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2021-01-01
Business code 621111
Sponsor’s telephone number 3155599936
Plan sponsor’s address 5415 WEST GENESEE STREET, SUITE 301, CAMILLUS, NY, 130312162
PREVENTIVE MEDICINE ASSOCIATES, PLLC, RETIREMENT PLAN 2023 161490162 2024-10-07 PREVENTIVE MEDICINE ASSOCIATES, PLLC 30
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2003-01-01
Business code 621340
Sponsor’s telephone number 3154878109
Plan sponsor’s address 5415 WEST GENESEE STREET, SUITE 301, CAMILLUS, NY, 130312162
PREVENTIVE MEDICINE ASSOCIATES, PLLC, 401(K) PROFIT SHARING PLAN 2023 161490162 2024-09-30 PREVENTIVE MEDICINE ASSOCIATES, PLLC 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621340
Sponsor’s telephone number 3154878109
Plan sponsor’s address 5415 WEST GENESEE STREET, SUITE 301, CAMILLUS, NY, 130312162

Signature of
Role Plan administrator
Date 2024-09-27
Name of individual signing KELLY SHACKLETON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-09-27
Name of individual signing KELLY SHACKLETON
Valid signature Filed with authorized/valid electronic signature
PREVENTIVE MEDICINE ASSOCIATES, PLLC CASH BALANCE PENSION PLAN 2022 161490162 2023-09-11 PREVENTIVE MEDICINE ASSOCIATES, PLLC 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2021-01-01
Business code 621111
Sponsor’s telephone number 3155599936
Plan sponsor’s address 5415 WEST GENESEE STREET, SUITE 301, CAMILLUS, NY, 130312162
PREVENTIVE MEDICINE ASSOCIATES, PLLC, 401(K) PROFIT SHARING PLAN 2022 161490162 2023-06-12 PREVENTIVE MEDICINE ASSOCIATES, PLLC 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621340
Sponsor’s telephone number 3154878109
Plan sponsor’s address 5415 WEST GENESEE STREET, SUITE 301, CAMILLUS, NY, 130312162

Signature of
Role Plan administrator
Date 2023-06-12
Name of individual signing KELLY SHACKLETON
Role Employer/plan sponsor
Date 2023-06-12
Name of individual signing KELLY SHACKLETON
PREVENTIVE MEDICINE ASSOCIATES, PLLC, RETIREMENT PLAN 2022 161490162 2023-09-11 PREVENTIVE MEDICINE ASSOCIATES, PLLC 24
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2003-01-01
Business code 621340
Sponsor’s telephone number 3154878109
Plan sponsor’s address 5415 WEST GENESEE STREET, SUITE 301, CAMILLUS, NY, 130312162
PREVENTIVE MEDICINE ASSOCIATES, PLLC, 401(K) PROFIT SHARING PLAN 2021 161490162 2022-03-15 PREVENTIVE MEDICINE ASSOCIATES, PLLC 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621340
Sponsor’s telephone number 3154878109
Plan sponsor’s address 5415 WEST GENESEE STREET, SUITE 301, CAMILLUS, NY, 130312162

Signature of
Role Plan administrator
Date 2022-03-14
Name of individual signing KELLY SHACKLETON
Role Employer/plan sponsor
Date 2022-03-14
Name of individual signing KELLY SHACKLETON
PREVENTIVE MEDICINE ASSOCIATES, PLLC, 401(K) PROFIT SHARING PLAN 2020 161490162 2021-04-12 PREVENTIVE MEDICINE ASSOCIATES, PLLC 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621340
Sponsor’s telephone number 3154878109
Plan sponsor’s address 5415 WEST GENESEE STREET, SUITE 301, CAMILLUS, NY, 130312162

Signature of
Role Plan administrator
Date 2021-04-09
Name of individual signing KELLY SHACKLETON
Role Employer/plan sponsor
Date 2021-04-09
Name of individual signing KELLY SHACKLETON
PREVENTIVE MEDICINE ASSOCIATES, PLLC, 401(K) PROFIT SHARING PLAN 2019 161490162 2020-04-23 PREVENTIVE MEDICINE ASSOCIATES, PLLC 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621340
Sponsor’s telephone number 3154878109
Plan sponsor’s address 5415 WEST GENESEE STREET, SUITE 301, CAMILLUS, NY, 130312162

Signature of
Role Plan administrator
Date 2020-04-23
Name of individual signing KELLY SHACKLETON
Role Employer/plan sponsor
Date 2020-04-23
Name of individual signing KELLY SHACKLETON
PREVENTIVE MEDICINE ASSOCIATES, PLLC, 401(K) PROFIT SHARING PLAN 2018 161490162 2019-07-02 PREVENTIVE MEDICINE ASSOCIATES, PLLC 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621340
Sponsor’s telephone number 3154878109
Plan sponsor’s address 5415 WEST GENESEE STREET, SUITE 301, CAMILLUS, NY, 130312162

Signature of
Role Plan administrator
Date 2019-07-02
Name of individual signing KELLY SHACKLETON
Role Employer/plan sponsor
Date 2019-07-02
Name of individual signing KELLY SHACKLETON

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 5415 WEST GENESEE ST, STE 301, CAMILLUS, NY, United States, 13031

History

Start date End date Type Value
1999-11-24 2003-11-05 Address 5414 WEST GENESEE ST, STE 301, CAMILLUS, NY, 13031, USA (Type of address: Service of Process)
1997-11-24 1999-11-24 Address 5415 WEST GENESEE ST.,, SUITE 301, CAMILLUS, NY, 13031, USA (Type of address: Service of Process)
1995-11-06 1997-11-24 Address 404 CHAPEL DRIVE, SYRACUSE, NY, 13219, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
190104060280 2019-01-04 BIENNIAL STATEMENT 2017-11-01
140528002194 2014-05-28 BIENNIAL STATEMENT 2013-11-01
120103002911 2012-01-03 BIENNIAL STATEMENT 2011-11-01
071127002226 2007-11-27 BIENNIAL STATEMENT 2007-11-01
051122002690 2005-11-22 BIENNIAL STATEMENT 2005-11-01
031105002208 2003-11-05 BIENNIAL STATEMENT 2003-11-01
011108002254 2001-11-08 BIENNIAL STATEMENT 2001-11-01
991124002184 1999-11-24 BIENNIAL STATEMENT 1999-11-01
971124002028 1997-11-24 BIENNIAL STATEMENT 1997-11-01
960117000130 1996-01-17 AFFIDAVIT OF PUBLICATION 1996-01-17

Related by officers

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Related by address

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Date of last update: 13 Nov 2024

Sources: New York Secretary of State

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