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 |
|
|