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INTERBORO SURGICAL ASSOCIATES, P.C.

Company Details

Name: INTERBORO SURGICAL ASSOCIATES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 10 Nov 2005 (19 years ago)
Entity Number: 3279497
County: Kings
Place of Formation: New York
Address: 19-02 WHITESTONE EXPRESSWAY, WHITESTONE, NY, United States, 11357
Address ZIP Code: 11357

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
INTERBORO SURGICAL ASSOCIATES, P.C. PENSION PLAN 2023 203923853 2024-08-20 INTERBORO SURGICAL ASSOCIATES, P.C. 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 7187480500
Plan sponsor’s address 1500 ROUTE 112, BLDG 8, SUITE B, PORT JEFFERSON STATION, NY, 11776

Signature of
Role Plan administrator
Date 2024-08-20
Name of individual signing GREGORY BREVETTI
INTERBORO SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING PLAN 2023 203923853 2024-08-20 INTERBORO SURGICAL ASSOCIATES, P.C. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-10-01
Business code 621111
Sponsor’s telephone number 7187480500
Plan sponsor’s address 1500 ROUTE 112, BLDG. 8, SUITE B, PORT JEFFERSON STATION, NY, 11776

Signature of
Role Plan administrator
Date 2024-08-20
Name of individual signing GREGORY BREVETTI
INTERBORO SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING PLAN 2022 203923853 2023-09-05 INTERBORO SURGICAL ASSOCIATES, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-10-01
Business code 621111
Sponsor’s telephone number 7187480500
Plan sponsor’s address 1500 ROUTE 112, BLDG. 8, SUITE B, PORT JEFFERSON STATION, NY, 11776

Signature of
Role Plan administrator
Date 2023-09-05
Name of individual signing GREGORY BREVETTI
INTERBORO SURGICAL ASSOCIATES, P.C. PENSION PLAN 2022 203923853 2023-09-22 INTERBORO SURGICAL ASSOCIATES, P.C. 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 7187480500
Plan sponsor’s address 1500 ROUTE 112, BLDG 8, SUITE B, PORT JEFFERSON STATION, NY, 11776

Signature of
Role Plan administrator
Date 2023-09-22
Name of individual signing GREGORY BREVETTI
INTERBORO SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING PLAN 2021 203923853 2022-09-21 INTERBORO SURGICAL ASSOCIATES, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-10-01
Business code 621111
Sponsor’s telephone number 7187480500
Plan sponsor’s address 1500 ROUTE 112, BLDG. 8, SUITE B, PORT JEFFERSON STATION, NY, 11776

Signature of
Role Plan administrator
Date 2022-09-21
Name of individual signing GREGORY BREVETTI
INTERBORO SURGICAL ASSOCIATES, P.C. PENSION PLAN 2021 203923853 2022-09-12 INTERBORO SURGICAL ASSOCIATES, P.C. 14
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 7187480500
Plan sponsor’s address 1500 ROUTE 112, BLDG 8, SUITE B, PORT JEFFERSON STATION, NY, 11776

Signature of
Role Plan administrator
Date 2022-09-12
Name of individual signing GREGORY BREVETTI
INTERBORO SURGICAL ASSOCIATES, P.C. PENSION PLAN 2021 203923853 2022-09-12 INTERBORO SURGICAL ASSOCIATES, P.C. 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 7187480500
Plan sponsor’s address 1500 ROUTE 112, BLDG 8, SUITE B, PORT JEFFERSON STATION, NY, 11776

Signature of
Role Plan administrator
Date 2022-09-12
Name of individual signing GREGORY BREVETTI
INTERBORO SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING PLAN 2020 203923853 2021-10-13 INTERBORO SURGICAL ASSOCIATES, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-10-01
Business code 621111
Sponsor’s telephone number 7187480500
Plan sponsor’s address 1500 ROUTE 112, BLDG. 8, SUITE B, PORT JEFFERSON STATION, NY, 11776

Signature of
Role Plan administrator
Date 2021-10-13
Name of individual signing GREGORY BREVETTI
INTERBORO SURGICAL ASSOCIATES, P.C. 401(K) PROFIT SHARING PLAN 2020 203923853 2021-10-13 INTERBORO SURGICAL ASSOCIATES, P.C. 12
Three-digit plan number (PN) 001
Effective date of plan 2007-10-01
Business code 621111
Sponsor’s telephone number 7187480500
Plan sponsor’s address 1500 ROUTE 112, BLDG. 8, SUITE B, PORT JEFFERSON STATION, NY, 11776

Plan administrator’s name and address
Administrator’s EIN 203923853
Plan administrator’s name INTERBORO SURGICAL ASSOCIATES, P.C.
Plan administrator’s address 8318 4TH AVENUE, BROOKLYN, NY, 11209
Administrator’s telephone number 7187480500

Signature of
Role Plan administrator
Date 2021-10-13
Name of individual signing GREGORY BREVETTI
INTERBORO SURGICAL ASSOCIATES, P.C. PENSION PLAN 2020 203923853 2021-10-11 INTERBORO SURGICAL ASSOCIATES, P.C. 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 7187480500
Plan sponsor’s address 1500 ROUTE 112, BLDG 8, SUITE B, PORT JEFFERSON STATION, NY, 11776

Signature of
Role Plan administrator
Date 2021-10-11
Name of individual signing GREGORY BREVETTI

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 19-02 WHITESTONE EXPRESSWAY, WHITESTONE, NY, United States, 11357

History

Start date End date Type Value
2005-11-10 2021-06-30 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
051110000026 2005-11-10 CERTIFICATE OF INCORPORATION 2005-11-10

Related by officers

THE CORPORATION

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Related by address

19-02 WHITESTONE EXPRESSWAY, WHITESTONE, NY, United States, 11357

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Date of last update: 10 Nov 2024

Sources: New York Secretary of State

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