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  5. FOREST HILLS MEDICAL SERVICES P.C.

FOREST HILLS MEDICAL SERVICES P.C.

Company Details

Name: FOREST HILLS MEDICAL SERVICES P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 24 Oct 1986 (39 years ago)
Entity Number: 1121715
ZIP code: 11375
County: Queens
Place of Formation: New York
Address: 108-16 63RD ROAD, FOREST HILLS, NY, United States, 11375

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
FOREST HILLS MEDICAL SERVICES, P.C. 401(K) PLAN 2023 112830151 2024-06-05 FOREST HILLS MEDICAL SERVICES, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-08-28
Business code 621111
Sponsor’s telephone number 7188975331
Plan sponsor’s address 108-16 63RD ROAD, FOREST HILLS, NY, 11375

Signature of
Role Plan administrator
Date 2024-06-05
Name of individual signing KELLY DURANTE
FOREST HILLS MEDICAL SERVICES, P.C. 401(K) PLAN 2022 112830151 2023-06-14 FOREST HILLS MEDICAL SERVICES, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-08-28
Business code 621111
Sponsor’s telephone number 7188975331
Plan sponsor’s address 108-16 63RD ROAD, FOREST HILLS, NY, 11375

Signature of
Role Plan administrator
Date 2023-06-14
Name of individual signing KELLY DURANTE
FOREST HILLS MEDICAL SERVICES, P.C. 401(K) PLAN 2021 112830151 2022-07-01 FOREST HILLS MEDICAL SERVICES, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 7188975331
Plan sponsor’s address 108-16 63RD ROAD, FOREST HILLS, NY, 11375

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2022-07-01
Name of individual signing KELLY DURANTE
FOREST HILLS MEDICAL SERVICES, P.C. 401(K) PLAN 2020 112830151 2021-11-05 FOREST HILLS MEDICAL SERVICES, P.C. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 7188975331
Plan sponsor’s address 108-16 63RD ROAD, FOREST HILLS, NY, 11375

Plan administrator’s name and address
Administrator’s EIN 474474775
Plan administrator’s name GUIDELINE, INC.
Plan administrator’s address 1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number 8882283491

Signature of
Role Plan administrator
Date 2021-11-05
Name of individual signing CAROL HO

DOS Process Agent

Name Role Address
JAMES GOHAR DOS Process Agent 108-16 63RD ROAD, FOREST HILLS, NY, United States, 11375

Chief Executive Officer

Name Role Address
JAMES GOHAR Chief Executive Officer 108-16 63RD ROAD, FOREST HILLS, NY, United States, 11375

History

Start date End date Type Value
2025-01-28 2025-01-29 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-10-28 2025-01-28 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-10-28 2024-10-28 Address 108-16 63RD ROAD, FOREST HILLS, NY, 11375, 1352, USA (Type of address: Chief Executive Officer)
2024-10-28 2024-10-28 Address 108-16 63RD ROAD, FOREST HILLS, NY, 11375, USA (Type of address: Chief Executive Officer)
2023-10-24 2024-10-28 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2023-02-16 2023-02-16 Address 108-16 63RD ROAD, FOREST HILLS, NY, 11375, USA (Type of address: Chief Executive Officer)
2023-02-16 2024-10-28 Address 108-16 63RD ROAD, FOREST HILLS, NY, 11375, USA (Type of address: Service of Process)
2023-02-16 2023-02-16 Address 108-16 63RD ROAD, FOREST HILLS, NY, 11375, 1352, USA (Type of address: Chief Executive Officer)
2023-02-16 2023-10-24 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2023-02-16 2024-10-28 Address 108-16 63RD ROAD, FOREST HILLS, NY, 11375, USA (Type of address: Chief Executive Officer)

Filings

Filing Number Date Filed Type Effective Date
241028000316 2024-10-28 BIENNIAL STATEMENT 2024-10-28
230216003233 2023-02-16 BIENNIAL STATEMENT 2022-10-01
181030006115 2018-10-30 BIENNIAL STATEMENT 2018-10-01
141030006201 2014-10-30 BIENNIAL STATEMENT 2014-10-01
140314002014 2014-03-14 AMENDMENT TO BIENNIAL STATEMENT 2012-10-01
121116002099 2012-11-16 BIENNIAL STATEMENT 2012-10-01
101020002795 2010-10-20 BIENNIAL STATEMENT 2010-10-01
080924002846 2008-09-24 BIENNIAL STATEMENT 2008-10-01
070130002765 2007-01-30 BIENNIAL STATEMENT 2006-10-01
041130002513 2004-11-30 BIENNIAL STATEMENT 2004-10-01

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3189707707 2020-05-01 0202 PPP 108-16 63RD ROAD, FOREST HILLS, NY, 11375
Loan Status Date 2021-05-20
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 109240
Loan Approval Amount (current) 109240
Undisbursed Amount 0
Franchise Name -
Lender Location ID 48270
Servicing Lender Name JPMorgan Chase Bank, National Association
Servicing Lender Address 1111 Polaris Pkwy, COLUMBUS, OH, 43240-2031
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address FOREST HILLS, QUEENS, NY, 11375-0001
Project Congressional District NY-06
Number of Employees 7
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 194093
Originating Lender Name JPMorgan Chase Bank, National Association
Originating Lender Address CHICAGO, IL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 110254.05
Forgiveness Paid Date 2021-04-08

Related by officers

JAMES GOHAR

J GOHAR MEDICAL P.C. JA GOHAR MEDICAL P.C. 25-15 CRESCENT STREET MEDICAL P.C.

Related by address

108-16 63RD ROAD, FOREST HILLS, NY, United States, 11375

PRESERVV MEDICAL, PLLC MARI SU, M.D. P.C.

Date of last update: 16 Mar 2025

Sources: New York Secretary of State

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