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  5. WILLIAM A. FACIBENE, M.D., P.C.

WILLIAM A. FACIBENE, M.D., P.C.

Company Details

Name: WILLIAM A. FACIBENE, M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 15 Apr 2002 (23 years ago)
Entity Number: 2754762
ZIP code: 11042
County: Nassau
Place of Formation: New York
Address: 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, United States, 11042

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
W.A. FACIBENE, M.D., P.C. 401(K) PS PLAN 2021 020612630 2022-09-14 WILLIAM A. FACIBENE M.D., P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5163524900
Plan sponsor’s address 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, 11042
W.A. FACIBENE, M.D., P.C. 401(K) PS PLAN 2021 020612630 2022-07-13 WILLIAM A. FACIBENE M.D., P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5163524900
Plan sponsor’s address 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, 11042

Signature of
Role Plan administrator
Date 2022-07-13
Name of individual signing WILLIAM A. FACIBENE
W.A. FACIBENE, M.D., P.C. 401(K) PS PLAN 2020 020612630 2021-07-13 WILLIAM A. FACIBENE M.D., P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5163524900
Plan sponsor’s address 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, 11042

Signature of
Role Plan administrator
Date 2021-07-13
Name of individual signing WILLIAM A. FACIBENE
W.A. FACIBENE, M.D., P.C. 401(K) PS PLAN 2019 020612630 2020-07-28 WILLIAM A. FACIBENE M.D., P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5163524900
Plan sponsor’s address 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, 11042

Signature of
Role Plan administrator
Date 2020-07-28
Name of individual signing WILLIAM A. FACIBENE
W.A. FACIBENE, M.D., P.C. 401(K) PS PLAN 2018 020612630 2019-09-21 WILLIAM A. FACIBENE M.D., P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5163524900
Plan sponsor’s address 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, 11042

Signature of
Role Plan administrator
Date 2019-09-21
Name of individual signing WILLIAM A. FACIBENE
W.A. FACIBENE, M.D., P.C. 401(K) PS PLAN 2017 020612630 2018-09-07 WILLIAM A. FACIBENE M.D., P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5163524900
Plan sponsor’s address 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, 11042

Plan administrator’s name and address
Administrator’s EIN 020612630
Plan administrator’s name WILLIAM A. FACIBENE M.D., P.C.
Plan administrator’s address 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, 11042
Administrator’s telephone number 5163524900
W.A. FACIBENE, M.D., P.C. 401(K) PS PLAN 2016 020612630 2017-05-07 WILLIAM A. FACIBENE M.D., P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5163524900
Plan sponsor’s address 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, 11042

Plan administrator’s name and address
Administrator’s EIN 020612630
Plan administrator’s name WILLIAM A. FACIBENE M.D., P.C.
Plan administrator’s address 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, 11042
Administrator’s telephone number 5163524900

Signature of
Role Plan administrator
Date 2017-05-07
Name of individual signing WILLIAM A. FACIBENE
W.A. FACIBENE, M.D., P.C. 401(K) PS PLAN 2015 020612630 2016-06-05 WILLIAM A. FACIBENE M.D., P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5163524900
Plan sponsor’s address 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, 11042

Plan administrator’s name and address
Administrator’s EIN 020612630
Plan administrator’s name WILLIAM A. FACIBENE M.D., P.C.
Plan administrator’s address 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, 11042
Administrator’s telephone number 5163524900

Signature of
Role Plan administrator
Date 2016-06-05
Name of individual signing WILLIAM A. FACIBENE
W.A. FACIBENE, M.D., P.C. 401(K) PS PLAN 2014 020612630 2015-05-20 WILLIAM A. FACIBENE M.D., P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5163524900
Plan sponsor’s address 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, 11042

Plan administrator’s name and address
Administrator’s EIN 020612630
Plan administrator’s name WILLIAM A. FACIBENE M.D., P.C.
Plan administrator’s address 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, 11042
Administrator’s telephone number 5163524900

Signature of
Role Plan administrator
Date 2015-05-20
Name of individual signing WILLIAM A. FACIBENE
W.A. FACIBENE, M.D., P.C. 401(K) PS PLAN 2013 020612630 2014-07-03 WILLIAM A. FACIBENE M.D., P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 5163524900
Plan sponsor’s address 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, 11042

Plan administrator’s name and address
Administrator’s EIN 020612630
Plan administrator’s name WILLIAM A. FACIBENE M.D., P.C.
Plan administrator’s address 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, 11042
Administrator’s telephone number 5163524900

Signature of
Role Plan administrator
Date 2014-07-03
Name of individual signing WILLIAM A. FACIBENE

DOS Process Agent

Name Role Address
WILLIAM FACIBENE DOS Process Agent 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, United States, 11042

Chief Executive Officer

Name Role Address
WILLIAM FACIBENE Chief Executive Officer 1999 MARCUS AVENUE, SUITE 102, LAKE SUCCESS, NY, United States, 11042

History

Start date End date Type Value
2006-07-18 2020-04-07 Address 1999 MARCUS AVE / SUITE 102, LAKE SUCCESS, NY, 11042, USA (Type of address: Principal Executive Office)
2006-07-18 2020-04-07 Address 1999 MARCUS AVE / SUITE 102, LAKE SUCCESS, NY, 11042, USA (Type of address: Chief Executive Officer)
2006-07-18 2020-04-07 Address 1999 MARCUS AVE / SUITE 102, LAKE SUCCESS, NY, 11042, USA (Type of address: Service of Process)
2004-05-05 2006-07-18 Address 444 LAKEVILLE ROAD, SUITE 202, LAKE SUCCESS, NY, 11042, 1165, USA (Type of address: Chief Executive Officer)
2004-05-05 2006-07-18 Address 444 LAKEVILLE ROAD, SUITE 202, LAKE SUCCESS, NY, 11042, 1165, USA (Type of address: Service of Process)
2004-05-05 2006-07-18 Address 444 LAKEVILLE ROAD, SUITE 202, LAKE SUCCESS, NY, 11042, 1165, USA (Type of address: Principal Executive Office)
2002-04-15 2004-05-05 Address ATTN WILLIAM A FACIBENE MD, 88 GREENWAY WEST, NEW HYDE PARK, NY, 11040, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
200407060179 2020-04-07 BIENNIAL STATEMENT 2020-04-01
140728006196 2014-07-28 BIENNIAL STATEMENT 2014-04-01
120713002302 2012-07-13 BIENNIAL STATEMENT 2012-04-01
100419002048 2010-04-19 BIENNIAL STATEMENT 2010-04-01
080416002413 2008-04-16 BIENNIAL STATEMENT 2008-04-01
060718002342 2006-07-18 BIENNIAL STATEMENT 2006-04-01
040505002159 2004-05-05 BIENNIAL STATEMENT 2004-04-01
020415000253 2002-04-15 CERTIFICATE OF INCORPORATION 2002-04-15

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 11 Nov 2024

Sources: New York Secretary of State

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