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  5. MUBEENA A. BALTI, PHYSICIAN, P.C.

MUBEENA A. BALTI, PHYSICIAN, P.C.

Company Details

Name: MUBEENA A. BALTI, PHYSICIAN, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Inactive
Date of registration: 25 Nov 1983 (41 years ago)
Date of dissolution: 15 Jul 2019
Entity Number: 812061
ZIP code: 14221
County: Erie
Place of Formation: New York
Address: 33 TURNBERRY DRIVE, WILLIAMSVILLE, NY, United States, 14221

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
MUBEENA A. BALTI, PHYSICIAN, P.C. PROFIT SHARING TRUST 2012 161204117 2013-07-01 MUBEENA A. BALTI, PHYSICIAN, P.C. 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1983-08-01
Business code 621111
Sponsor’s telephone number 7168368380
Plan sponsor’s address 350 ALBERTA DRIVE, AMHERST, NY, 14226

Signature of
Role Plan administrator
Date 2013-07-01
Name of individual signing MUBEENA A. BALTI, M.D.
MUBEENA A. BALTI, PHYSICIAN, P.C. PROFIT SHARING TRUST 2012 161204117 2013-06-10 MUBEENA A. BALTI, PHYSICIAN, P.C. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1983-08-01
Business code 621111
Sponsor’s telephone number 7168368380
Plan sponsor’s address 350 ALBERTA DRIVE, AMHERST, NY, 14226

Signature of
Role Plan administrator
Date 2013-06-10
Name of individual signing MUBEENA A. BALTI M.D.
MUBEENA A. BALTI, PHYSICIAN, P.C. PROFIT SHARING TRUST 2011 161204117 2012-07-25 MUBEENA A. BALTI, PHYSICIAN, P.C. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1983-08-01
Business code 621111
Sponsor’s telephone number 7168368380
Plan sponsor’s address 350 ALBERTA DRIVE, AMHERST, NY, 14226

Plan administrator’s name and address
Administrator’s EIN 161204117
Plan administrator’s name MUBEENA A. BALTI, PHYSICIAN, P.C.
Plan administrator’s address 350 ALBERTA DRIVE, AMHERST, NY, 14226
Administrator’s telephone number 7168368380

Signature of
Role Plan administrator
Date 2012-07-25
Name of individual signing MUBEENA A. BALTI M.D.
MUBEENA A BALTI, PHYSICIAN, PC PROFIT SHARING TRUST 2010 161204117 2011-10-05 MUBEENA A BALTI, PHYSICIAN, P.C. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1983-08-01
Business code 621111
Sponsor’s telephone number 7168368380
Plan sponsor’s address 350 ALBERTA DRIVE, SUITE 207, AMHERST, NY, 14226

Plan administrator’s name and address
Administrator’s EIN 161204117
Plan administrator’s name MUBEENA A BALTI, PHYSICIAN, P.C.
Plan administrator’s address 350 ALBERTA DRIVE, SUITE 207, AMHERST, NY, 14226
Administrator’s telephone number 7168368380

Signature of
Role Plan administrator
Date 2011-10-05
Name of individual signing MUBEENA A. BALTI MD

DOS Process Agent

Name Role Address
MUBEENA A. BALTI, M.D. DOS Process Agent 33 TURNBERRY DRIVE, WILLIAMSVILLE, NY, United States, 14221

History

Start date End date Type Value
1983-11-25 2019-07-15 Address 3385 BAILEY AVE., BUFFALO, NY, 14215, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
190715000533 2019-07-15 CERTIFICATE OF CHANGE (BY AGENT) 2019-07-15
190715000536 2019-07-15 CERTIFICATE OF DISSOLUTION 2019-07-15
B042927-4 1983-11-25 CERTIFICATE OF INCORPORATION 1983-11-25

Related by officers

No related officers

Related by address

33 TURNBERRY DRIVE, WILLIAMSVILLE, NY, United States, 14221

CARRUBBA'S CHICKEN PIT LLC

Date of last update: 16 Nov 2024

Sources: New York Secretary of State

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