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  5. SALVATORE J. PALUMBO, M.D., P.C.

SALVATORE J. PALUMBO, M.D., P.C.

Company Details

Name: SALVATORE J. PALUMBO, M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 28 Jul 2003 (21 years ago)
Entity Number: 2935374
ZIP code: 11730
County: Suffolk
Place of Formation: New York
Address: 22 The Moor, EAST ISLIP, NY, United States, 11730
Principal Address: 380 MONTAUK HWY, WEST ISLIP, NY, United States, 11795

Contact Details

Phone +1 631-422-5371

Shares Details

Shares issued 200

Share Par Value 0.01

Type PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SALVATORE J. PALUMBO, M.D., P.C. 2015 432023476 2016-06-30 SALVATORE J. PALUMBO, M.D., P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6314225371
Plan sponsor’s address 1175 MONTAUK HIGHWAY, SUITE 6, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2016-06-13
Name of individual signing SALVATORE PALUMBO
Role Employer/plan sponsor
Date 2016-06-13
Name of individual signing SALVATORE PALUMBO
SALVATORE J. PALUMBO, M.D., P.C. 2014 432023476 2015-07-27 SALVATORE J. PALUMBO, M.D., P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6314225371
Plan sponsor’s address 1175 MONTAUK HIGHWAY, SUITE 6, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2015-07-27
Name of individual signing SALVATORE PALUMBO
Role Employer/plan sponsor
Date 2015-07-27
Name of individual signing SALVATORE PALUMBO
SALVATORE J. PALUMBO, M.D., P.C. 2013 432023476 2014-10-08 SALVATORE J. PALUMBO, M.D., P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6314225371
Plan sponsor’s address 1175 MONTAUK HIGHWAY, SUITE 6, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2014-10-08
Name of individual signing SALVATORE PALUMBO
Role Employer/plan sponsor
Date 2014-10-08
Name of individual signing SALVATORE PALUMBO
SALVATORE J. PALUMBO, M.D., P.C. 2012 432023476 2013-07-11 SALVATORE J. PALUMBO, M.D., P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6314225371
Plan sponsor’s address 1175 MONTAUK HIGHWAY, SUITE 6, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2013-07-11
Name of individual signing SALVATORE PALUMBO
Role Employer/plan sponsor
Date 2013-07-11
Name of individual signing SALVATORE PALUMBO
SALVATORE J. PALUMBO, M.D., P.C. 2011 432023476 2012-07-17 SALVATORE J. PALUMBO, M.D., P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6314225371
Plan sponsor’s address 1175 MONTAUK HIGHWAY, SUITE 6, WEST ISLIP, NY, 11795

Plan administrator’s name and address
Administrator’s EIN 432023476
Plan administrator’s name SALVATORE J. PALUMBO, M.D., P.C.
Plan administrator’s address 1175 MONTAUK HIGHWAY, SUITE 6, WEST ISLIP, NY, 11795
Administrator’s telephone number 6314225371

Signature of
Role Plan administrator
Date 2012-07-17
Name of individual signing SALVATORE PALUMBO
Role Employer/plan sponsor
Date 2012-07-17
Name of individual signing SALVATORE PALUMBO
SALVATORE J. PALUMBO, M.D., P.C. 2010 432023476 2011-07-22 SALVATORE J. PALUMBO, M.D., P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6314225371
Plan sponsor’s address 1175 MONTAUK HIGHWAY, SUITE 6, WEST ISLIP, NY, 11795

Plan administrator’s name and address
Administrator’s EIN 432023476
Plan administrator’s name SALVATORE J. PALUMBO, M.D., P.C.
Plan administrator’s address 1175 MONTAUK HIGHWAY, SUITE 6, WEST ISLIP, NY, 11795
Administrator’s telephone number 6314225371

Signature of
Role Plan administrator
Date 2011-07-21
Name of individual signing SALVATORE PALUMBO
Role Employer/plan sponsor
Date 2011-07-21
Name of individual signing SALVATORE PALUMBO
SALVATORE J. PALUMBO, M.D., P.C. 2009 432023476 2010-10-01 SALVATORE J. PALUMBO, M.D., P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6314225371
Plan sponsor’s address 1175 MONTAUK HIGHWAY, SUITE 6, WEST ISLIP, NY, 11795

Plan administrator’s name and address
Administrator’s EIN 432023476
Plan administrator’s name SALVATORE J. PALUMBO, M.D., P.C.
Plan administrator’s address 1175 MONTAUK HIGHWAY, SUITE 6, WEST ISLIP, NY, 11795
Administrator’s telephone number 6314225371

Signature of
Role Plan administrator
Date 2010-10-01
Name of individual signing SALVATORE PALUMBO
Role Employer/plan sponsor
Date 2010-10-01
Name of individual signing SALVATORE PALUMBO

DOS Process Agent

Name Role Address
SALVATORE J. PALUMBO, M.D., P.C. DOS Process Agent 22 The Moor, EAST ISLIP, NY, United States, 11730

Chief Executive Officer

Name Role Address
SALVATORE J PALUMBO, MD Chief Executive Officer 380 MONTAUK HWY, WEST ISLIP, NY, United States, 11795

History

Start date End date Type Value
2023-07-12 2023-07-12 Address 380 MONTAUK HWY, WEST ISLIP, NY, 11795, USA (Type of address: Chief Executive Officer)
2023-07-12 2023-07-12 Address 1175 MONTAUK HWY, STE 6, WEST ISLIP, NY, 11795, USA (Type of address: Chief Executive Officer)
2022-05-14 2023-07-12 Address 380 MONTAUK HWY, WEST ISLIP, NY, 11795, USA (Type of address: Chief Executive Officer)
2022-05-14 2023-07-12 Address 1175 MONTAUK HWY, STE 6, WEST ISLIP, NY, 11795, USA (Type of address: Chief Executive Officer)
2022-05-14 2022-05-14 Address 1175 MONTAUK HWY, STE 6, WEST ISLIP, NY, 11795, USA (Type of address: Chief Executive Officer)
2022-05-14 2023-07-12 Address 22 the moor, EAST ISLIP, NY, 11730, USA (Type of address: Service of Process)
2022-05-14 2022-05-14 Address 380 MONTAUK HWY, WEST ISLIP, NY, 11795, USA (Type of address: Chief Executive Officer)
2021-08-17 2023-07-12 Shares Share type: PAR VALUE, Number of shares: 200, Par value: 0.01
2005-10-18 2022-05-14 Address 1175 MONTAUK HWY, WEST ISLIP, NY, 11795, USA (Type of address: Service of Process)
2005-10-18 2022-05-14 Address 1175 MONTAUK HWY, STE 6, WEST ISLIP, NY, 11795, USA (Type of address: Chief Executive Officer)

Filings

Filing Number Date Filed Type Effective Date
230712001965 2023-07-12 BIENNIAL STATEMENT 2023-07-01
220126000334 2022-01-26 BIENNIAL STATEMENT 2022-01-26
220514000603 2021-08-17 CERTIFICATE OF CHANGE BY ENTITY 2021-08-17
051018002037 2005-10-18 BIENNIAL STATEMENT 2005-07-01
030728000571 2003-07-28 CERTIFICATE OF INCORPORATION 2003-07-28

Related by officers

No related officers

Related by address

380 MONTAUK HWY, WEST ISLIP, NY, United States, 11795

BORIMIR DARAKCHIEV MD P.C. BRIAN J MCHUGH MD, P.C. ERIC FANAEE, M.D., P.C. GEORGE KAKOULIDES, M.D., P.C. SOUTH SHORE MEDICAL SERVICES, PLLC SYMEON MISSIOS, MD P.C. WILLIAM E. MCCORMICK, M.D., P.C.

Date of last update: 10 Nov 2024

Sources: New York Secretary of State

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