| Name: | DR. FAZELI & DR. BROUMAND, LLC |
| Jurisdiction: | New York |
| Legal type: | DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY |
| Status: | Active |
| Date of registration: | 29 Jun 2006 (18 years ago) |
| Entity Number: | 3382879 |
| County: | Onondaga |
| Place of Formation: | New York |
| Address: | 4110 MEDICAL CENTER DR, FAYETTEVILLE, NY, United States, 13066 |
| Address ZIP Code: | 13066 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DACNY, PLLC DEFINED BENEFIT PLAN | 2023 | 300382092 | 2024-09-10 | DR. FAZELI & DR. BROUMAND, LLC | 42 | |||||||||||||||||||||||
|
||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2024-09-03 |
| Name of individual signing | AMIN FAZELI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1986-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3156630100 |
| Plan sponsor’s address | 4110 MEDICAL CENTER DR, FAYETTEVILLE, NY, 13066 |
Signature of
| Role | Plan administrator |
| Date | 2024-10-02 |
| Name of individual signing | AMIN FAZELI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1986-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3156630100 |
| Plan sponsor’s address | 4110 MEDICAL CENTER DR, FAYETTEVILLE, NY, 13066 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-19 |
| Name of individual signing | AMIN FAZELI |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2009-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3156630100 |
| Plan sponsor’s address | 4110 MEDICAL CENTER DR, FAYETTEVILLE, NY, 13066 |
Signature of
| Role | Plan administrator |
| Date | 2023-08-01 |
| Name of individual signing | AMIN FAZELI |
| Name | Role | Address |
|---|---|---|
| DR. FAZELI & DR. BROUMAND, LLC | DOS Process Agent | 4110 MEDICAL CENTER DR, FAYETTEVILLE, NY, United States, 13066 |
| Start date | End date | Type | Value |
|---|---|---|---|
| 2010-07-07 | 2015-12-02 | Address | 4110 MEDICAL CENTER DR, FAYETTEVILLE, NY, 13066, USA (Type of address: Service of Process) |
| 2008-06-09 | 2010-07-07 | Address | 4110 MEDICAL CENTER DR, FAYETTEVILLE, NY, 13066, USA (Type of address: Service of Process) |
| 2006-06-29 | 2008-06-09 | Address | 100 WHITE SPRUCE BLVD, ROCHESTER, NY, 14623, USA (Type of address: Service of Process) |
| Filing Number | Date Filed | Type | Effective Date |
|---|---|---|---|
| 200604060158 | 2020-06-04 | BIENNIAL STATEMENT | 2020-06-01 |
| 180607006487 | 2018-06-07 | BIENNIAL STATEMENT | 2018-06-01 |
| 160606007403 | 2016-06-06 | BIENNIAL STATEMENT | 2016-06-01 |
| 151202007009 | 2015-12-02 | BIENNIAL STATEMENT | 2014-06-01 |
| 120814002094 | 2012-08-14 | BIENNIAL STATEMENT | 2012-06-01 |
| 110304000268 | 2011-03-04 | CERTIFICATE OF AMENDMENT | 2011-03-04 |
| 100707002379 | 2010-07-07 | BIENNIAL STATEMENT | 2010-06-01 |
| 080609003205 | 2008-06-09 | BIENNIAL STATEMENT | 2008-06-01 |
| 071010000793 | 2007-10-10 | CERTIFICATE OF PUBLICATION | 2007-10-10 |
| 060629000351 | 2006-06-29 | ARTICLES OF ORGANIZATION | 2006-06-29 |
Date of last update: 09 Nov 2024
Sources: New York Secretary of State
