EAST END PAIN MANAGEMENT 401(K) PLAN
|
2018
|
010765430
|
2019-09-26
|
EAST END PAIN MANAGEMENT, LLC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
6317022300
|
Plan sponsor’s
address |
365 COUNTY ROAD 39A, SUITE 15, SOUTHAMPTON, NY, 11968
|
Signature of
Role |
Plan administrator |
Date |
2019-09-26 |
Name of individual signing |
JUAN J GARGIULO |
|
Role |
Employer/plan sponsor |
Date |
2019-09-26 |
Name of individual signing |
JUAN J GARGIULO |
|
|
EAST END PAIN MANAGEMENT 401(K) PLAN
|
2018
|
010765430
|
2019-07-22
|
EAST END PAIN MANAGEMENT, LLC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
6317022300
|
Plan sponsor’s
address |
365 COUNTY ROAD 39A, SUITE 15, SOUTHAMPTON, NY, 11968
|
Signature of
Role |
Plan administrator |
Date |
2019-07-22 |
Name of individual signing |
MARIA VOIKLIS |
|
Role |
Employer/plan sponsor |
Date |
2019-07-22 |
Name of individual signing |
JUAN GARGIULO |
|
|
EAST END PAIN MANAGEMENT 401(K) PLAN
|
2017
|
010765430
|
2018-10-10
|
EAST END PAIN MANAGEMENT, LLC
|
9
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
6317022300
|
Plan sponsor’s
address |
365 COUNTY ROAD 39A, SUITE 15, SOUTHAMPTON, NY, 11968
|
Signature of
Role |
Plan administrator |
Date |
2018-10-10 |
Name of individual signing |
JUAN J GARGIULO |
|
|
EAST END PAIN MANAGEMENT 401(K) PLAN
|
2016
|
010765430
|
2017-08-29
|
EAST END PAIN MANAGEMENT, LLC
|
8
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
6317022300
|
Plan sponsor’s
address |
365 COUNTY ROAD 39A, SUITE 15, SOUTHAMPTON, NY, 11968
|
Signature of
Role |
Plan administrator |
Date |
2017-08-29 |
Name of individual signing |
JUAN GARGIULO |
|
|
EAST END PAIN MANAGEMENT 401(K) PLAN
|
2015
|
010765430
|
2016-09-20
|
EAST END PAIN MANAGEMENT, LLC
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
6317022300
|
Plan sponsor’s
address |
365 COUNTY ROAD 39A, SUITE 15, SOUTHAMPTON, NY, 11968
|
Signature of
Role |
Plan administrator |
Date |
2016-09-20 |
Name of individual signing |
JAUN J GARGIULO MD |
|
Role |
Employer/plan sponsor |
Date |
2016-09-20 |
Name of individual signing |
JAUN J GARGIULO MD |
|
|
EAST END PAIN MANAGEMENT 401(K) PLAN
|
2014
|
010765430
|
2015-10-07
|
EAST END PAIN MANAGEMENT, LLC
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
6317022300
|
Plan sponsor’s
address |
365 COUNTY ROAD 39A, SUITE 15, SOUTHAMPTON, NY, 11968
|
Signature of
Role |
Plan administrator |
Date |
2015-10-07 |
Name of individual signing |
JUAN J GARGIULO |
|
|
EAST END PAIN MANAGEMENT 401(K) PLAN
|
2013
|
010765430
|
2014-09-23
|
EAST END PAIN MANAGEMENT, LLC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
6317022300
|
Plan sponsor’s
address |
365 COUNTY ROAD 39A, SUITE 15, SOUTHAMPTON, NY, 11968
|
Signature of
Role |
Plan administrator |
Date |
2014-09-23 |
Name of individual signing |
JUAN J GARGIULO |
|
|
EAST END PAIN MANAGEMENT 401(K) PLAN
|
2012
|
010765430
|
2013-10-02
|
EAST END PAIN MANAGEMENT, LLC
|
6
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
6317022300
|
Plan sponsor’s
address |
365 COUNTY ROAD 39A, SUITE 15, SOUTHAMPTON, NY, 11968
|
Signature of
Role |
Plan administrator |
Date |
2013-10-02 |
Name of individual signing |
MARIA VOIKLIS |
|
Role |
Employer/plan sponsor |
Date |
2013-10-02 |
Name of individual signing |
JUAN GARGIULO |
|
|
EAST END PAIN MANAGEMENT 401(K) PLAN
|
2011
|
010765430
|
2012-09-20
|
EAST END PAIN MANAGEMENT, LLC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
6317022300
|
Plan sponsor’s
address |
365 COUNTY ROAD 39A, SUITE 15, SOUTHAMPTON, NY, 11968
|
Plan administrator’s name and address
Administrator’s EIN |
010765430 |
Plan administrator’s name |
EAST END PAIN MANAGEMENT, LLC |
Plan administrator’s
address |
365 COUNTY ROAD 39A, SUITE 15, SOUTHAMPTON, NY, 11968 |
Administrator’s telephone number |
6317022300 |
Signature of
Role |
Plan administrator |
Date |
2012-09-20 |
Name of individual signing |
JUAN GARGIULO |
|
Role |
Employer/plan sponsor |
Date |
2012-09-20 |
Name of individual signing |
JUAN GARGIULO |
|
|
EAST END PAIN MANAGEMENT 401(K) PLAN
|
2010
|
010765430
|
2011-10-05
|
EAST END PAIN MANAGEMENT, LLC
|
7
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2005-10-01
|
Business code |
621111
|
Sponsor’s telephone number |
6317022300
|
Plan sponsor’s
address |
365 COUNTY ROAD 39A, SUITE 15, SOUTHAMPTON, NY, 11968
|
Plan administrator’s name and address
Administrator’s EIN |
010765430 |
Plan administrator’s name |
EAST END PAIN MANAGEMENT, LLC |
Plan administrator’s
address |
365 COUNTY ROAD 39A, SUITE 15, SOUTHAMPTON, NY, 11968 |
Administrator’s telephone number |
6317022300 |
Signature of
Role |
Plan administrator |
Date |
2011-10-05 |
Name of individual signing |
MARIA VOIKLIS |
|
|