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BACK KIM, M.D., P.C.

Company Details

Name: BACK KIM, M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 05 Mar 1997 (28 years ago)
Entity Number: 2119307
County: Nassau
Place of Formation: New York
Principal Address: 125-10 QUEENS BLVD., STE. 2709, KEW GARDENS, NY, United States, 11415
Principal Address ZIP Code: 11415
Address: 125-10 QUEENS BLVD STE 2709, KEW GARDENS, NY, United States, 11415
Address ZIP Code: 11415

Contact Details

Phone +1 212-226-8000

Phone +1 212-266-8000

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
BACK KIM, M.D., P.C. DEFINED BENEFIT PENSION PLAN 2020 113371665 2021-03-17 BACK KIM, M.D., P.C. 1
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2122268000
Plan sponsor’s address 727 6TH AVE., NEW YORK, NY, 10010
BACK KIM, M.D., P.C. DEFINED BENEFIT PENSION PLAN 2019 113371665 2020-10-12 BACK KIM, M.D., P.C. 1
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2122268000
Plan sponsor’s address 727 6TH AVE., NEW YORK, NY, 10010
BACK KIM, M.D., P.C. DEFINED BENEFIT PENSION PLAN 2018 113371665 2019-10-13 BACK KIM, M.D., P.C. 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7189979000
Plan sponsor’s address 727 6TH AVE., NEW YORK, NY, 10010
BACK KIM, M.D., P.C. DEFINED BENEFIT PENSION PLAN 2017 113371665 2018-10-15 BACK KIM, M.D., P.C. 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7189979000
Plan sponsor’s address 136-20 38TH AVE., STE 8J, FLUSHING, NY, 11354
BACK KIM, M.D., P.C. DEFINED BENEFIT PENSION PLAN 2016 113371665 2017-10-14 BACK KIM, M.D., P.C. 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7189979000
Plan sponsor’s address 136-20 38TH AVE., STE 8J, FLUSHING, NY, 11354
BACK KIM, M.D., P.C. DEFINED BENEFIT PENSION PLAN 2015 113371665 2016-10-14 BACK KIM, M.D., P.C. 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7189979000
Plan sponsor’s address 136-20 38TH AVE., STE 8J, FLUSHING, NY, 11354
BACK KIM, M.D., P.C. DEFINED BENEFIT PENSION PLAN 2014 113371665 2015-10-15 BACK KIM, M.D., P.C. 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7189979000
Plan sponsor’s address 136-20 38TH AVE., STE 8J, FLUSHING, NY, 11354
BACK KIM, M.D., P.C. DEFINED BENEFIT PENSION PLAN 2013 113371665 2014-10-16 BACK KIM, M.D., P.C. 9
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7189979000
Plan sponsor’s address 136-20 38TH AVE., STE 8J, FLUSHING, NY, 11354
BACK KIM, M.D., P.C. DEFINED BENEFIT PENSION PLAN 2012 113371665 2013-10-14 BACK KIM, M.D., P.C. 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7189979000
Plan sponsor’s address 125-10 QUEENS BLVD., #2709, KEW GARDENS, NY, 11415

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing BACK KIM, M.D.
Role Employer/plan sponsor
Date 2013-10-14
Name of individual signing BACK KIM, M.D.
BACK KIM, M.D., P.C. DEFINED BENEFIT PENSION PLAN 2011 113371665 2012-10-15 BACK KIM, M.D., P.C. 9
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 7189979000
Plan sponsor’s address 125-10 QUEENS BLVD., #2709, KEW GARDENS, NY, 11415

Plan administrator’s name and address
Administrator’s EIN 113371665
Plan administrator’s name BACK KIM, M.D., P.C.
Plan administrator’s address 125-10 QUEENS BLVD., #2709, KEW GARDENS, NY, 11415
Administrator’s telephone number 7189979000

Signature of
Role Plan administrator
Date 2012-10-15
Name of individual signing BACK KIM, M.D.
Role Employer/plan sponsor
Date 2012-10-15
Name of individual signing BACK KIM, M.D.

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 125-10 QUEENS BLVD STE 2709, KEW GARDENS, NY, United States, 11415

Chief Executive Officer

Name Role Address
BACK KIM, M.D. Chief Executive Officer 125-10 QUEENS BLVD., SUITE 2709, KEW GARDENS, NY, United States, 11415

History

Start date End date Type Value
2001-08-10 2005-04-15 Address 11 LAKE RD. WEST, LAKE SUCCESS, NY, 11020, USA (Type of address: Service of Process)
1999-07-15 2001-08-10 Address 136-30 MAPLE AVE, FLUSHING, NY, 11355, USA (Type of address: Chief Executive Officer)
1999-07-15 2001-08-10 Address 136-30 MAPLE AVE, FLUSHING, NY, 11355, USA (Type of address: Principal Executive Office)
1999-07-15 2001-08-10 Address 11 LAKE ROAD WEST, LAKE SUCESS, NY, 11020, USA (Type of address: Service of Process)
1997-03-05 1999-07-15 Address 95 BAY DRIVEWAY, PLANDOME, NY, 11030, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
110404002344 2011-04-04 BIENNIAL STATEMENT 2011-03-01
090428002773 2009-04-28 BIENNIAL STATEMENT 2009-03-01
070626002310 2007-06-26 BIENNIAL STATEMENT 2007-03-01
050415002122 2005-04-15 BIENNIAL STATEMENT 2005-03-01
010810002454 2001-08-10 BIENNIAL STATEMENT 2001-03-01
990715002444 1999-07-15 BIENNIAL STATEMENT 1999-03-01
970305000220 1997-03-05 CERTIFICATE OF INCORPORATION 1997-03-05

Related by officers

THE CORPORATION

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Related by address

125-10 QUEENS BLVD STE 2709, KEW GARDENS, NY, United States, 11415

QUEENS CROSSING 8IJ, LLC

Date of last update: 12 Nov 2024

Sources: New York Secretary of State

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