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  5. MAVERICK FAMILY MEDICAL, P.C.

MAVERICK FAMILY MEDICAL, P.C.

Company Details

Name: MAVERICK FAMILY MEDICAL, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 19 Feb 1998 (27 years ago)
Date of dissolution: 21 Jun 2017
Entity Number: 2230522
ZIP code: 12498
County: Ulster
Place of Formation: New York
Principal Address: 404 ZENA ROAD, WOODSTOCK, NY, United States, 12498
Address: MAVERICK FAMILY HEALTH, 404 ZENA ROAD, WOODSTOCK, NY, United States, 12498

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
MAVERICK FAMILY MEDICAL P C 401 K PROFIT SHARING PLAN TRUST 2013 141802249 2014-10-02 MAVERICK FAMILY MEDICAL P C 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 8456795293
Plan sponsor’s address 404 ZENA RD, WOODSTOCK, NY, 124982626

Signature of
Role Plan administrator
Date 2014-10-02
Name of individual signing RANDALL RISSMAN
MAVERICK FAMILY MEDICAL P C 401 K PROFIT SHARING PLAN TRUST 2012 141802249 2013-07-25 MAVERICK FAMILY MEDICAL P C 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 8456795293
Plan sponsor’s address 404 ZENA RD, WOODSTOCK, NY, 124982626

Signature of
Role Plan administrator
Date 2013-07-25
Name of individual signing MAVERICK FAMILY MEDICAL P C
MAVERICK FAMILY MEDICAL P C 401 K PROFIT SHARING PLAN TRUST 2011 141802249 2012-07-31 MAVERICK FAMILY MEDICAL P C 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 8456795293
Plan sponsor’s address 404 ZENA RD, WOODSTOCK, NY, 124982626

Plan administrator’s name and address
Administrator’s EIN 141802249
Plan administrator’s name MAVERICK FAMILY MEDICAL P C
Plan administrator’s address 404 ZENA RD, WOODSTOCK, NY, 124982626
Administrator’s telephone number 8456795293

Signature of
Role Plan administrator
Date 2012-07-31
Name of individual signing MAVERICK FAMILY MEDICAL P C
MAVERICK FAMILY MEDICAL P C 401 K PROFIT SHARING PLAN TRUST 2010 141802249 2011-07-27 MAVERICK FAMILY MEDICAL P C 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 8456795293
Plan sponsor’s address 404 ZENA RD, WOODSTOCK, NY, 124980000

Plan administrator’s name and address
Administrator’s EIN 141802249
Plan administrator’s name MAVERICK FAMILY MEDICAL P C
Plan administrator’s address 404 ZENA RD, WOODSTOCK, NY, 124980000
Administrator’s telephone number 8456795293

Signature of
Role Plan administrator
Date 2011-07-27
Name of individual signing MAVERICK FAMILY MEDICAL P C
MAVERICK FAMILY MEDICAL P C 2009 141802249 2010-07-20 MAVERICK FAMILY MEDICAL P C 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 8456795293
Plan sponsor’s address 404 ZENA RD, WOODSTOCK, NY, 124980000

Plan administrator’s name and address
Administrator’s EIN 141802249
Plan administrator’s name MAVERICK FAMILY MEDICAL P C
Plan administrator’s address 404 ZENA RD, WOODSTOCK, NY, 124980000
Administrator’s telephone number 8456795293

Signature of
Role Plan administrator
Date 2010-07-20
Name of individual signing MAVERICK FAMILY MEDICAL P C

Chief Executive Officer

Name Role Address
RANDALL RISSMAN MD Chief Executive Officer 404 ZENA ROAD, WOODSTOCK, NY, United States, 12498

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent MAVERICK FAMILY HEALTH, 404 ZENA ROAD, WOODSTOCK, NY, United States, 12498

History

Start date End date Type Value
2000-05-25 2002-02-11 Address 401 ZENA ROAD, WOODSTOCK, NY, 12498, USA (Type of address: Chief Executive Officer)
2000-05-25 2002-02-11 Address 401 ZENA ROAD, WOODSTOCK, NY, 12498, USA (Type of address: Principal Executive Office)
2000-05-25 2002-02-11 Address MAVERICK FAMILY HEALTH, 401 ZENA ROAD, WOODSTOCK, NY, 12498, USA (Type of address: Service of Process)
1998-02-19 2000-05-25 Address 401 ZENA ROAD, WOODSTOCK, NY, 12498, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
170621000351 2017-06-21 CERTIFICATE OF DISSOLUTION 2017-06-21
140321002348 2014-03-21 BIENNIAL STATEMENT 2014-02-01
120202002049 2012-02-02 BIENNIAL STATEMENT 2012-02-01
100301002331 2010-03-01 BIENNIAL STATEMENT 2010-02-01
060414002124 2006-04-14 BIENNIAL STATEMENT 2006-02-01
040217002020 2004-02-17 BIENNIAL STATEMENT 2004-02-01
020211002412 2002-02-11 BIENNIAL STATEMENT 2002-02-01
000525002021 2000-05-25 BIENNIAL STATEMENT 2000-02-01
980219000536 1998-02-19 CERTIFICATE OF INCORPORATION 1998-02-19

Related by officers

THE CORPORATION

ARSHIA DESIGNS INC. AAA VACUUM CORP. ATLANTICA TELECOM, INC. MISTY SPORTSWEAR, INC. INRACKS, INC. FAT JAMS ELECTRONICS INC. CROQUEMBOUCHE, INC. LONG BEACH PEDIATRIC GROUP, P.C. LAW OFFICES OF JOSEPH A. GRECO, P.C. TEREZ, INC.

Related by address

404 ZENA ROAD, WOODSTOCK, NY, United States, 12498

MAVERICK MEDICAL BUILDING ASSOCIATES INC.

Date of last update: 12 Nov 2024

Sources: New York Secretary of State

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