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  5. PECONIC EAR, NOSE, THROAT & FACIAL PLASTIC SURGERY, P.C.

PECONIC EAR, NOSE, THROAT & FACIAL PLASTIC SURGERY, P.C.

Company Details

Name: PECONIC EAR, NOSE, THROAT & FACIAL PLASTIC SURGERY, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 07 Nov 2005 (19 years ago)
Date of dissolution: 14 Feb 2013
Entity Number: 3277980
ZIP code: 11931
County: Suffolk
Place of Formation: New York
Address: P.O. BOX 2668, AQUEBOQUE, NY, United States, 11931
Principal Address: PO BOX 2668, 292 SHADETREE LANE, AQUEBOQUE, NY, United States, 11931

Shares Details

Shares issued 1000

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY, P.C. PROFIT SHARING PLAN AND TRUST 2011 203800653 2012-08-01 PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY P.C. 20
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6317278050
Plan sponsor’s address P.O. BOX 2814, AQUEBOGUE, NY, 119312814

Plan administrator’s name and address
Administrator’s EIN 203800653
Plan administrator’s name PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY P.C.
Plan administrator’s address P.O. BOX 2814, AQUEBOGUE, NY, 119312814
Administrator’s telephone number 6317278050

Signature of
Role Plan administrator
Date 2012-08-01
Name of individual signing KEVIN BRAAT
Role Employer/plan sponsor
Date 2012-08-01
Name of individual signing KEVIN BRAAT
PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY, P.C. PROFIT SHARING PLAN AND TRUST 2011 203800653 2012-08-08 PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY P.C. 20
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6317278050
Plan sponsor’s address P.O. BOX 2814, AQUEBOGUE, NY, 119312814

Plan administrator’s name and address
Administrator’s EIN 203800653
Plan administrator’s name PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY P.C.
Plan administrator’s address P.O. BOX 2814, AQUEBOGUE, NY, 119312814
Administrator’s telephone number 6317278050

Signature of
Role Plan administrator
Date 2012-08-08
Name of individual signing KEVIN BRAAT
Role Employer/plan sponsor
Date 2012-08-08
Name of individual signing KEVIN BRAAT
PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY, P.C. DEFINED BENEFIT PENSION PLAN 2011 203800653 2012-06-15 PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY P.C. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6317278050
Plan sponsor’s address P.O. BOX 2668, AQUEBOGUE, NY, 119312668

Plan administrator’s name and address
Administrator’s EIN 203800653
Plan administrator’s name PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY P.C.
Plan administrator’s address P.O. BOX 2668, AQUEBOGUE, NY, 119312668
Administrator’s telephone number 6317278050

Signature of
Role Plan administrator
Date 2012-06-15
Name of individual signing KEVIN BRAAT
Role Employer/plan sponsor
Date 2012-06-15
Name of individual signing KEVIN BRAAT
PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY, P.C. PROFIT SHARING PLAN AND TRUST 2010 203800653 2011-09-19 PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY P.C. 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6317278050
Plan sponsor’s address P.O. BOX 2668, AQUEBOGUE, NY, 119312668

Plan administrator’s name and address
Administrator’s EIN 203800653
Plan administrator’s name PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY P.C.
Plan administrator’s address P.O. BOX 2668, AQUEBOGUE, NY, 119312668
Administrator’s telephone number 6317278050

Signature of
Role Plan administrator
Date 2011-09-19
Name of individual signing KEVIN BRAAT
Role Employer/plan sponsor
Date 2011-09-19
Name of individual signing KEVIN BRAAT
PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY, P.C. DEFINED BENEFIT PENSION PLAN 2010 203800653 2011-09-09 PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY P.C. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 6317278050
Plan sponsor’s address P.O. BOX 2668, AQUEBOGUE, NY, 119312668

Plan administrator’s name and address
Administrator’s EIN 203800653
Plan administrator’s name PECONIC EAR NOSE THROAT & FACIAL PLASTIC SURGERY P.C.
Plan administrator’s address P.O. BOX 2668, AQUEBOGUE, NY, 119312668
Administrator’s telephone number 6317278050

Signature of
Role Plan administrator
Date 2011-09-09
Name of individual signing KEVIN BRAAT
Role Employer/plan sponsor
Date 2011-09-09
Name of individual signing KEVIN BRAAT

Chief Executive Officer

Name Role Address
KEVIN BRAAT, MD Chief Executive Officer PO BOX 2668, AQUEBOQUE, NY, United States, 11931

DOS Process Agent

Name Role Address
KEVIN BRAAT, M.D. DOS Process Agent P.O. BOX 2668, AQUEBOQUE, NY, United States, 11931

Filings

Filing Number Date Filed Type Effective Date
130214001102 2013-02-14 CERTIFICATE OF DISSOLUTION 2013-02-14
091104002581 2009-11-04 BIENNIAL STATEMENT 2009-11-01
071114002404 2007-11-14 BIENNIAL STATEMENT 2007-11-01
051107000332 2005-11-07 CERTIFICATE OF INCORPORATION 2005-11-07

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 10 Nov 2024

Sources: New York Secretary of State

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