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SAMUEL SHATKIN JR., M.D., PLLC

Company Details

Name: SAMUEL SHATKIN JR., M.D., PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 25 Oct 2007 (17 years ago)
Entity Number: 3585152
County: Erie
Place of Formation: New York
Address: 2500 KENSINGTON AVENUE, AMHERST, NY, United States, 14226
Address ZIP Code: 14226

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SAMUEL SHATKIN, JR., M.D., PLLC CASH BALANCE PLAN 2020 562677930 2021-07-21 SAMUEL SHATKIN, JR., M.D., PLLC 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-05
Business code 621111
Sponsor’s telephone number 7168391700
Plan sponsor’s address 2500 KENSINGTON AVE., AMHERST, NY, 14226

Signature of
Role Plan administrator
Date 2021-07-21
Name of individual signing SAMUEL SHATKIN
Role Employer/plan sponsor
Date 2021-07-21
Name of individual signing SAMUEL SHATKIN
SAMUEL SHATKIN, JR., M.D., PLLC CASH BALANCE PLAN 2019 562677930 2020-10-13 SAMUEL SHATKIN, JR., M.D., PLLC 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-05
Business code 621111
Sponsor’s telephone number 7168391700
Plan sponsor’s address 2500 KENSINGTON AVE., AMHERST, NY, 14226

Signature of
Role Plan administrator
Date 2020-10-13
Name of individual signing SAMUEL SHATKIN
Role Employer/plan sponsor
Date 2020-10-13
Name of individual signing SAMUEL SHATKIN
SAMUEL SHATKIN, JR., M.D., PLLC CASH BALANCE PLAN 2018 562677930 2019-10-11 SAMUEL SHATKIN, JR., M.D., PLLC 21
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-05
Business code 621111
Sponsor’s telephone number 7168391700
Plan sponsor’s address 2500 KENSINGTON AVE., AMHERST, NY, 14226

Signature of
Role Plan administrator
Date 2019-10-11
Name of individual signing SAMUEL SHATKIN
Role Employer/plan sponsor
Date 2019-10-11
Name of individual signing SAMUEL SHATKIN
SAMUEL SHATKIN, JR., M.D., PLLC CASH BALANCE PLAN 2017 562677930 2018-10-03 SAMUEL SHATKIN, JR., M.D., PLLC 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-05
Business code 621111
Sponsor’s telephone number 7168391700
Plan sponsor’s address 2500 KENSINGTON AVE., AMHERST, NY, 14226

Signature of
Role Plan administrator
Date 2018-10-02
Name of individual signing SAMUEL SHATKIN
Role Employer/plan sponsor
Date 2018-10-02
Name of individual signing SAMUEL SHATKIN
SAMUEL SHATKIN, JR., M.D., PLLC CASH BALANCE PLAN 2016 562677930 2017-10-13 SAMUEL SHATKIN, JR., M.D., PLLC 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-05
Business code 621111
Sponsor’s telephone number 7168391700
Plan sponsor’s address 2500 KENSINGTON AVE., AMHERST, NY, 14226

Signature of
Role Plan administrator
Date 2017-10-13
Name of individual signing SAMUEL SHATKIN
Role Employer/plan sponsor
Date 2017-10-13
Name of individual signing SAMUEL SHATKIN
SAMUEL SHATKIN, JR., M.D., PLLC CASH BALANCE PLAN 2015 562677930 2016-10-11 SAMUEL SHATKIN, JR., M.D., PLLC 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-05
Business code 621111
Sponsor’s telephone number 7168391700
Plan sponsor’s address 2500 KENSINGTON AVE., AMHERST, NY, 14226

Signature of
Role Plan administrator
Date 2016-10-10
Name of individual signing SAMUEL SHATKIN JR
Role Employer/plan sponsor
Date 2016-10-10
Name of individual signing SAMUEL SHATKIN JR
SAMUEL SHATKIN, JR., M.D., PLLC CASH BALANCE PLAN 2014 562677930 2015-10-13 SAMUEL SHATKIN, JR., M.D., PLLC 15
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2008-01-05
Business code 621111
Sponsor’s telephone number 7168391700
Plan sponsor’s address 2500 KENSINGTON AVE., AMHERST, NY, 14226

Signature of
Role Plan administrator
Date 2015-10-12
Name of individual signing SAMUEL SHATKIN JR
SAMUEL SHATKIN, JR., M.D., PLLC RETIREMENT PLAN 2013 562677930 2014-10-15 SAMUEL SHATKIN, JR., M.D., PLLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-05
Business code 621111
Sponsor’s telephone number 7168391700
Plan sponsor’s address 2500 KENSINGTON AVENUE, AMHERST, NY, 14226

Signature of
Role Plan administrator
Date 2014-10-14
Name of individual signing SAMUEL SHATKIN
Role Employer/plan sponsor
Date 2014-10-14
Name of individual signing SAMUEL SHATKIN
SAMUEL SHATKIN, JR., M.D., PLLC RETIREMENT PLAN 2012 562677930 2013-09-27 SAMUEL SHATKIN, JR., M.D., PLLC 17
Three-digit plan number (PN) 001
Effective date of plan 2008-01-05
Business code 621111
Sponsor’s telephone number 7168391700
Plan sponsor’s address 2500 KENSINGTON AVENUE, AMHERST, NY, 14226

Signature of
Role Plan administrator
Date 2013-09-26
Name of individual signing SAMUEL SHATKIN
Role Employer/plan sponsor
Date 2013-09-26
Name of individual signing SAMUEL SHATKIN
SAMUEL SHATKIN, JR., M.D., PLLC RETIREMENT PLAN 2012 562677930 2014-10-09 SAMUEL SHATKIN, JR., M.D., PLLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-05
Business code 621111
Sponsor’s telephone number 7168391700
Plan sponsor’s address 2500 KENSINGTON AVENUE, AMHERST, NY, 14226

Signature of
Role Plan administrator
Date 2014-10-09
Name of individual signing SAMUEL SHATKIN
Role Employer/plan sponsor
Date 2014-10-09
Name of individual signing SAMUEL SHATKIN

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 2500 KENSINGTON AVENUE, AMHERST, NY, United States, 14226

Filings

Filing Number Date Filed Type Effective Date
191003060012 2019-10-03 BIENNIAL STATEMENT 2019-10-01
170403000455 2017-04-03 CERTIFICATE OF PUBLICATION 2017-04-03
151002006035 2015-10-02 BIENNIAL STATEMENT 2015-10-01
131010006387 2013-10-10 BIENNIAL STATEMENT 2013-10-01
111103002697 2011-11-03 BIENNIAL STATEMENT 2011-10-01
091013002542 2009-10-13 BIENNIAL STATEMENT 2009-10-01
071025000787 2007-10-25 ARTICLES OF ORGANIZATION 2007-10-25

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Related by address

2500 KENSINGTON AVENUE, AMHERST, NY, United States, 14226

2500 KENSINGTON LLC AESTHETIC TRAINING CENTER LLC GREAT LOOK PRODUCTS INC. INTERNATIONAL SOCIETY OF AESTHETIC MEDICAL PROFESSIONALS INC. SHATKIN ENTERTAINMENT, LLC

Date of last update: 09 Nov 2024

Sources: New York Secretary of State

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