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  5. SMITH HAVEN PEDIATRICS, PLLC

SMITH HAVEN PEDIATRICS, PLLC

Company Details

Name: SMITH HAVEN PEDIATRICS, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 02 Jan 2014 (11 years ago)
Entity Number: 4507476
ZIP code: 11787
County: Suffolk
Place of Formation: New York
Address: 269 D E. MAIN STREET, SMITHTOWN, NY, United States, 11787

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THE SMITH HAVEN PEDIATRICS MONEY PURCHASE PENSION PLAN 2017 112956074 2018-06-28 SMITH HAVEN PEDIATRICS 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 6313612121
Plan sponsor’s address 269D EAST MAIN STREET, SMITHTOWN, NY, 11787

Signature of
Role Plan administrator
Date 2018-06-27
Name of individual signing RICHARD SOSULSKI
Role Employer/plan sponsor
Date 2018-06-27
Name of individual signing RICHARD SOSULSKI
THE SMITH HAVEN PEDIATRICS 401(K) PROFIT SHARING PLAN 2017 112956074 2018-06-28 SMITH HAVEN PEDIATRICS 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 6313612121
Plan sponsor’s address 269D EAST MAIN STREET, SMITHTOWN, NY, 11787

Signature of
Role Plan administrator
Date 2018-06-27
Name of individual signing RICHARD SOSULSKI
Role Employer/plan sponsor
Date 2018-06-27
Name of individual signing RICHARD SOSULSKI
THE SMITH HAVEN PEDIATRICS MONEY PURCHASE PENSION PLAN 2016 112956074 2017-09-14 SMITH HAVEN PEDIATRICS 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 6313612121
Plan sponsor’s address 269D EAST MAIN STREET, SMITHTOWN, NY, 11787

Signature of
Role Plan administrator
Date 2017-09-13
Name of individual signing RICHARD SOSULSKI
Role Employer/plan sponsor
Date 2017-09-13
Name of individual signing RICHARD SOSULSKI
THE SMITH HAVEN PEDIATRICS 401(K) PROFIT SHARING PLAN 2016 112956074 2017-09-14 SMITH HAVEN PEDIATRICS 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 6313612121
Plan sponsor’s address 269D EAST MAIN STREET, SMITHTOWN, NY, 11787

Signature of
Role Plan administrator
Date 2017-09-13
Name of individual signing RICHARD SOSULSKI
Role Employer/plan sponsor
Date 2017-09-13
Name of individual signing RICHARD SOSULSKI
THE SMITH HAVEN PEDIATRICS 401(K) PROFIT SHARING PLAN 2015 112956074 2016-10-07 SMITH HAVEN PEDIATRICS 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 6313612121
Plan sponsor’s address 269D EAST MAIN STREET, SMITHTOWN, NY, 11787

Signature of
Role Plan administrator
Date 2016-10-06
Name of individual signing RICHARD SOSULSKI
Role Employer/plan sponsor
Date 2016-10-06
Name of individual signing RICHARD SOSULSKI
THE SMITH HAVEN PEDIATRICS MONEY PURCHASE PENSION PLAN 2015 112956074 2016-10-07 SMITH HAVEN PEDIATRICS 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 6313612121
Plan sponsor’s address 269D EAST MAIN STREET, SMITHTOWN, NY, 11787

Signature of
Role Plan administrator
Date 2016-10-06
Name of individual signing RICHARD SOSULSKI
Role Employer/plan sponsor
Date 2016-10-06
Name of individual signing RICHARD SOSULSKI
THE SMITH HAVEN PEDIATRICS 401(K) PROFIT SHARING PLAN 2014 112956074 2015-10-06 SMITH HAVEN PEDIATRICS 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 6313612121
Plan sponsor’s address 269D EAST MAIN STREET, SMITHTOWN, NY, 11787

Signature of
Role Plan administrator
Date 2015-10-05
Name of individual signing RICHARD SOSULSKI
Role Employer/plan sponsor
Date 2015-10-05
Name of individual signing RICHARD SOSULSKI
THE SMITH HAVEN PEDIATRICS MONEY PURCHASE PENSION PLAN 2014 112956074 2015-10-06 SMITH HAVEN PEDIATRICS 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 6313612121
Plan sponsor’s address 269D EAST MAIN STREET, SMITHTOWN, NY, 11787

Signature of
Role Plan administrator
Date 2015-10-05
Name of individual signing RICHARD SOSULSKI
Role Employer/plan sponsor
Date 2015-10-05
Name of individual signing RICHARD SOSULSKI
THE SMITH HAVEN PEDIATRICS MONEY PURCHASE PENSION PLAN 2013 112956074 2014-10-14 SMITH HAVEN PEDIATRICS 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 6313612121
Plan sponsor’s address 269D EAST MAIN STREET, SMITHTOWN, NY, 11787

Signature of
Role Plan administrator
Date 2014-10-13
Name of individual signing RICHARD SOSULSKI
Role Employer/plan sponsor
Date 2014-10-13
Name of individual signing RICHARD SOSULSKI
THE SMITH HAVEN PEDIATRICS 401(K) PROFIT SHARING PLAN 2013 112956074 2014-10-14 SMITH HAVEN PEDIATRICS 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 6313612121
Plan sponsor’s address 269D EAST MAIN STREET, SMITHTOWN, NY, 11787

Signature of
Role Plan administrator
Date 2014-10-13
Name of individual signing RICHARD SOSULSKI
Role Employer/plan sponsor
Date 2014-10-13
Name of individual signing RICHARD SOSULSKI

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 269 D E. MAIN STREET, SMITHTOWN, NY, United States, 11787

Filings

Filing Number Date Filed Type Effective Date
140102000184 2014-01-02 ARTICLES OF ORGANIZATION 2014-01-02

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269 D E. MAIN STREET, SMITHTOWN, NY, United States, 11787

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Date of last update: 24 Nov 2024

Sources: New York Secretary of State

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