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EMPIRE DERMATOLOGY, PLLC

Company Details

Name: EMPIRE DERMATOLOGY, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 25 Feb 2016 (9 years ago)
Entity Number: 4902375
County: Onondaga
Place of Formation: New York
Address: 5823 WIDEWATERS PARKWAY, EAST SYRACUSE, NY, United States, 13057
Address ZIP Code: 13057

Contact Details

Phone +1 315-500-7546

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EMPIRE DERMATOLOGY 401(K) PROFIT SHARING PLAN 2023 811896212 2024-03-12 EMPIRE DERMATOLOGY 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-02-01
Business code 621111
Sponsor’s telephone number 3153784210
Plan sponsor’s address 5823 WIDEWATERS PKWY, DEWITT, NY, 13057

Signature of
Role Plan administrator
Date 2024-03-12
Name of individual signing BRIAN RAPHAEL
EMPIRE DERMATOLOGY 401(K) PROFIT SHARING PLAN 2023 811896212 2024-10-10 EMPIRE DERMATOLOGY 95
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 3153991978
Plan sponsor’s address 5823 WIDEWATERS PARKWAY, E. SYRACUSE, NY, 13057

Signature of
Role Plan administrator
Date 2024-10-10
Name of individual signing BRIAN RAPHAEL
Valid signature Filed with authorized/valid electronic signature
EMPIRE DERMATOLOGY 401(K) PROFIT SHARING PLAN 2023 811896212 2024-03-12 EMPIRE DERMATOLOGY 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-02-01
Business code 621111
Sponsor’s telephone number 3153784210
Plan sponsor’s address 5823 WIDEWATERS PKWY, E. SYRACUSE, NY, 13057

Signature of
Role Plan administrator
Date 2024-03-12
Name of individual signing BRIAN RAPHAEL
EMPIRE DERMATOLOGY 401(K) PROFIT SHARING PLAN 2022 811896212 2023-07-19 EMPIRE DERMATOLOGY 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 3153991979
Plan sponsor’s address 5823 WIDEWATERS PARKWAY, E. SYRACUSE, NY, 13057

Signature of
Role Plan administrator
Date 2023-07-19
Name of individual signing BRIAN RAPHAEL
EMPIRE DERMATOLOGY 401(K) PROFIT SHARING PLAN 2021 811896212 2024-03-12 EMPIRE DERMATOLOGY 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-02-01
Business code 621111
Sponsor’s telephone number 3155007546
Plan sponsor’s address 5823 WIDEWATERS PKWY, E. SYRACUSE, NY, 13057

Signature of
Role Plan administrator
Date 2024-03-12
Name of individual signing BRIAN RAPHAEL
EMPIRE DERMATOLOGY 401(K) PROFIT SHARING PLAN 2021 818196212 2022-04-12 EMPIRE DERMATOLOGY 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-02-01
Business code 621111
Sponsor’s telephone number 3155007546
Plan sponsor’s address 5823 WIDEWATERS PKWY, E. SYRACUSE, NY, 13057

Signature of
Role Plan administrator
Date 2022-04-12
Name of individual signing BRIAN RAPHAEL
Role Employer/plan sponsor
Date 2022-04-12
Name of individual signing BRIAN RAPHAEL
EMPIRE DERMATOLOGY 2020 818196212 2021-04-05 EMPIRE DERMATOLOGY 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-02-01
Business code 621111
Sponsor’s telephone number 3153784210
Plan sponsor’s address 5823 WIDEWATERS PKWY, E. SYRACUSE, NY, 13057

Signature of
Role Plan administrator
Date 2021-04-01
Name of individual signing BRIAN RAPHAEL
Role Employer/plan sponsor
Date 2021-04-01
Name of individual signing BRIAN RAPHAEL
EMPIRE DERMATOLOGY 2019 818196212 2020-04-30 EMPIRE DERMATOLOGY 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-02-01
Business code 621111
Sponsor’s telephone number 3153784210
Plan sponsor’s address 5823 WIDEWATERS PKWY, DEWITT, NY, 13057

Signature of
Role Plan administrator
Date 2020-04-30
Name of individual signing BRIAN RAPHAEL
Role Employer/plan sponsor
Date 2020-04-30
Name of individual signing BRIAN RAPHAEL

DOS Process Agent

Name Role Address
EMPIRE DERMATOLOGY, PLLC DOS Process Agent 5823 WIDEWATERS PARKWAY, EAST SYRACUSE, NY, United States, 13057

History

Start date End date Type Value
2020-12-08 2021-12-30 Address 5823 WIDEWATERS PARKWAY, EAST SYRACUSE, NY, 13057, USA (Type of address: Service of Process)
2016-02-25 2020-12-08 Address 7301 DARTMOOR CROSSING, FAYETTEVILLE, NY, 13066, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
211230001682 2021-12-29 CERTIFICATE OF AMENDMENT 2021-12-29
201208060680 2020-12-08 BIENNIAL STATEMENT 2020-02-01
160428000257 2016-04-28 CERTIFICATE OF PUBLICATION 2016-04-28
160225000544 2016-02-25 ARTICLES OF ORGANIZATION 2016-02-25

Related by officers

No related officers

Related by address

5823 WIDEWATERS PARKWAY, EAST SYRACUSE, NY, United States, 13057

EMPIRE AESTHETICS, LLC IMPERIUM HEALTHCARE CONSULTING, LLC METROTECH COMMUNICATIONS, LLC UNITED COMMUNICATIONS CAPITAL CORPORATION CNY INTERNISTS, P.C. RSM MEDICAL ASSOCIATES, PLLC

Date of last update: 05 Nov 2024

Sources: New York Secretary of State

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