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PREMIER MEDICAL PLLC

Company Details

Name: PREMIER MEDICAL PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 24 Sep 2002 (22 years ago)
Entity Number: 2815427
County: Richmond
Place of Formation: New York
Address: 1975 HYLAN BLVD., STATEN ISLAND, NY, United States, 10306
Address ZIP Code: 10306

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PREMIER MEDICAL, PLLC CASH BALANCE PLAN 2023 223871742 2024-09-23 PREMIER MEDICAL, PLLC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314
PREMIER MEDICAL PLLC RETIREMENT PLAN 2023 223871742 2024-09-23 PREMIER MEDICAL, PLLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314
PREMIER MEDICAL, PLLC CASH BALANCE PLAN 2022 223871742 2023-09-05 PREMIER MEDICAL, PLLC 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2023-09-05
Name of individual signing JEFFRY TAMBOR
PREMIER MEDICAL PLLC RETIREMENT PLAN 2022 223871742 2023-09-05 PREMIER MEDICAL, PLLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2023-09-05
Name of individual signing JEFFRY TAMBOR
PREMIER MEDICAL, PLLC CASH BALANCE PLAN 2021 223871742 2022-09-06 PREMIER MEDICAL, PLLC 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2022-09-06
Name of individual signing JEFFRY TAMBOR
PREMIER MEDICAL PLLC RETIREMENT PLAN 2021 223871742 2022-09-06 PREMIER MEDICAL, PLLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2022-09-06
Name of individual signing JEFFRY TAMBOR
PREMIER MEDICAL PLLC RETIREMENT PLAN 2020 223871742 2021-09-13 PREMIER MEDICAL, PLLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2021-09-13
Name of individual signing JEFFRY TAMBOR
PREMIER MEDICAL, PLLC CASH BALANCE PLAN 2020 223871742 2021-09-13 PREMIER MEDICAL, PLLC 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2021-09-13
Name of individual signing JEFFRY TAMBOR
PREMIER MEDICAL PLLC RETIREMENT PLAN 2019 223871742 2020-10-02 PREMIER MEDICAL, PLLC 17
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2020-10-02
Name of individual signing JEFFRY TAMBOR
PREMIER MEDICAL, PLLC CASH BALANCE PLAN 2019 223871742 2020-10-02 PREMIER MEDICAL, PLLC 13
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2020-10-02
Name of individual signing JEFFRY TAMBOR

DOS Process Agent

Name Role Address
JEFFREY TAMBOR, M.D. DOS Process Agent 1975 HYLAN BLVD., STATEN ISLAND, NY, United States, 10306

Filings

Filing Number Date Filed Type Effective Date
080827002321 2008-08-27 BIENNIAL STATEMENT 2008-09-01
060906002365 2006-09-06 BIENNIAL STATEMENT 2006-09-01
020924000770 2002-09-24 ARTICLES OF ORGANIZATION 2002-09-24

Related by officers

No related officers

Related by address

1975 HYLAN BLVD., STATEN ISLAND, NY, United States, 10306

INN BY THE WAYSIDE PARACHUTE CLUB, INC. RRC ACCOUNT MANAGEMENT CORP. 1975 HYLAN BLVD. CORP. SUNRISE MEDICAL PRACTICE P.C. INN BY THE WAYSIDE INC.

Date of last update: 11 Nov 2024

Sources: New York Secretary of State

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