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SOUTH SHORE CHIROPRACTIC, PLLC

Company Details

Name: SOUTH SHORE CHIROPRACTIC, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 25 Apr 2000 (25 years ago)
Entity Number: 2502539
County: Richmond
Place of Formation: New York
Address: 639 SINCLAIR AVENUE, STATEN ISLAND, NY, United States, 10312
Address ZIP Code: 10312

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTH SHORE CHIROPRACTIC, PLLC 401 (K) PSP 2016 134115873 2017-10-05 SOUTH SHORE CHIROPRACTIC, PLLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-10-01
Business code 621310
Sponsor’s telephone number 7189674646
Plan sponsor’s mailing address 639 SINCLAIR AVE, STATEN ISLAND, NY, 103122643
Plan sponsor’s address 639 SINCLAIR AVE, STATEN ISLAND, NY, 103122643

Number of participants as of the end of the plan year
Active participants 0
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 0
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2017-10-05
Name of individual signing ELLIOTT COLLINS
Valid signature Filed with authorized/valid electronic signature
SOUTH SHORE CHIROPRACTIC, PLLC 401(K) PSP 2015 134115873 2016-10-12 SOUTH SHORE CHIROPRACTIC, PLLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-10-01
Business code 621310
Sponsor’s telephone number 7189674646
Plan sponsor’s mailing address 639 SINCLAIR AVE, STATEN ISLAND, NY, 103122643
Plan sponsor’s address 639 SINCLAIR AVE, STATEN ISLAND, NY, 103122643

Number of participants as of the end of the plan year
Active participants 1
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 1
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2016-10-12
Name of individual signing ELLIOTT COLLINS
Valid signature Filed with authorized/valid electronic signature
SOUTH SHORE CHIROPRACTIC, PLLC 401(K) PSP 2014 134115873 2015-10-14 SOUTH SHORE CHIROPRACTIC, PLLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-10-01
Business code 621310
Sponsor’s telephone number 7189674646
Plan sponsor’s mailing address 439 SINCLAIR AVENUE, STATEN ISLAND, NY, 10312
Plan sponsor’s address 439 SINCLAIR AVENUE, STATEN ISLAND, NY, 10312

Number of participants as of the end of the plan year
Active participants 1
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 1
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0
SOUTH SHORE CHIROPRACTIC, PLLC 401 (K) PSP 2013 134115873 2014-09-08 SOUTH SHORE CHIROPRACTIC, PLLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-10-01
Business code 621310
Sponsor’s telephone number 7189674646
Plan sponsor’s mailing address 639 SINCLAIR AVENUE, STATEN ISLAND, NY, 10312
Plan sponsor’s address 639 SINCLAIR AVENUE, STATEN ISLAND, NY, 10312

Number of participants as of the end of the plan year
Active participants 1
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 1
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2014-09-08
Name of individual signing CINDY MADISON
Valid signature Filed with authorized/valid electronic signature
SOUTH SHORE CHIROPRACTIC, PLLC 401(K) PSP 2012 134115873 2013-10-09 SOUTH SHORE CHIROPRACTIC, PLLC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-10-01
Business code 621310
Sponsor’s telephone number 7189674646
Plan sponsor’s mailing address 639 SINCLAIR AVENUE, STATEN ISLAND, NY, 10312
Plan sponsor’s address 639 SINCLAIR AVENUE, STATEN ISLAND, NY, 10312

Number of participants as of the end of the plan year
Active participants 1
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 1
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2013-10-09
Name of individual signing CINDY MADISON
Valid signature Filed with authorized/valid electronic signature
SOUTH SHORE CHIROPRACTIC, PLLC 401(K) PSP 2011 134115873 2012-10-19 SOUTH SHORE CHIROPRACTIC, PLLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-10-01
Business code 621310
Sponsor’s telephone number 7189674646
Plan sponsor’s mailing address 639 SINCLAIR AVENUE, STATEN ISLAND, NY, 10312
Plan sponsor’s address 639 SINCLAIR AVENUE, STATEN ISLAND, NY, 10312

Plan administrator’s name and address
Administrator’s EIN 134115873
Plan administrator’s name SOUTH SHORE CHIROPRACTIC, PLLC
Plan administrator’s address 639 SINCLAIR AVENUE, STATEN ISLAND, NY, 10312
Administrator’s telephone number 7189674646

Number of participants as of the end of the plan year
Active participants 2
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 1
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-10-19
Name of individual signing DOROTHY LONGOBARDI
Valid signature Filed with authorized/valid electronic signature
SOUTH SHORE CHIROPRACTIC, PLLC 401(K) PSP 2011 134115873 2012-10-12 SOUTH SHORE CHIROPRACTIC, PLLC 0
Three-digit plan number (PN) 001
Effective date of plan 2010-10-01
Business code 621310
Sponsor’s telephone number 7189674646
Plan sponsor’s mailing address 639 SINCLAIR AVENUE, STATEN ISLAND, NY, 10312
Plan sponsor’s address 639 SINCLAIR AVENUE, STATEN ISLAND, NY, 10312

Plan administrator’s name and address
Administrator’s EIN 134115873
Plan administrator’s name SOUTH SHORE CHIROPRACTIC, PLLC
Plan administrator’s address 639 SINCLAIR AVENUE, STATEN ISLAND, NY, 10312
Administrator’s telephone number 7189674646

Number of participants as of the end of the plan year
Active participants 2
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 1
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-10-12
Name of individual signing DOROTHY LONGOBARDI
Valid signature Filed with authorized/valid electronic signature

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 639 SINCLAIR AVENUE, STATEN ISLAND, NY, United States, 10312

Filings

Filing Number Date Filed Type Effective Date
120530002846 2012-05-30 BIENNIAL STATEMENT 2012-04-01
100505002796 2010-05-05 BIENNIAL STATEMENT 2010-04-01
080512002671 2008-05-12 BIENNIAL STATEMENT 2008-04-01
060403002020 2006-04-03 BIENNIAL STATEMENT 2006-04-01
040409002650 2004-04-09 BIENNIAL STATEMENT 2004-04-01
020416002122 2002-04-16 BIENNIAL STATEMENT 2002-04-01
000725000108 2000-07-25 AFFIDAVIT OF PUBLICATION 2000-07-25
000629000071 2000-06-29 AFFIDAVIT OF PUBLICATION 2000-06-29
000425000183 2000-04-25 ARTICLES OF ORGANIZATION 2000-04-25

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Related by address

639 SINCLAIR AVENUE, STATEN ISLAND, NY, United States, 10312

RAPHAEL J. OSHEROFF, M.D., F.A.C.P., P.C. TRIBOROUGH HEALTH & MEDICAL DIAGNOSTIC SERVICES, P.C. TRIBOROUGH MEDICAL AND HEALTH DIAGNOSTIC AND TREATMENT, P.C.

Date of last update: 11 Nov 2024

Sources: New York Secretary of State

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