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  5. SCOTIA - GLENVILLE FAMILY MEDICINE, P.C.

SCOTIA - GLENVILLE FAMILY MEDICINE, P.C.

Company Details

Name: SCOTIA - GLENVILLE FAMILY MEDICINE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 26 Jan 1987 (38 years ago)
Entity Number: 1139547
ZIP code: 12019
County: Schenectady
Place of Formation: New York
Address: CHRISTOPHER BUFF DO, 112 CHARLTON RD, BALLSTON LAKE, NY, United States, 12019
Principal Address: 112 CHARLTON RD, BALLSTON LAKE, NY, United States, 12019

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
SCOTIA-GLENVILLE FAMILY MEDICINE, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2013 141691508 2014-02-21 SCOTIA-GLENVILLE FAMILY MEDICINE, P.C. 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 5183997723
Plan sponsor’s address 112 CHARLTON ROAD, BALLSTON LAKE, NY, 12019

Signature of
Role Plan administrator
Date 2014-02-21
Name of individual signing BECKY KONG
SCOTIA-GLENVILLE FAMILY MEDICINE, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2012 141691508 2013-06-14 SCOTIA-GLENVILLE FAMILY MEDICINE, P.C. 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 5183997723
Plan sponsor’s address 112 CHARLTON ROAD, BALLSTON LAKE, NY, 12019

Signature of
Role Plan administrator
Date 2013-06-14
Name of individual signing BECKY KONG
SCOTIA-GLENVILLE FAMILY MEDICINE, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2011 141691508 2012-10-10 SCOTIA-GLENVILLE FAMILY MEDICINE, P.C. 44
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 5183997723
Plan sponsor’s address 112 CHARLTON ROAD, BALLSTON LAKE, NY, 12019

Plan administrator’s name and address
Administrator’s EIN 141691508
Plan administrator’s name SCOTIA-GLENVILLE FAMILY MEDICINE, P.C.
Plan administrator’s address 112 CHARLTON ROAD, BALLSTON LAKE, NY, 12019
Administrator’s telephone number 5183997723

Signature of
Role Plan administrator
Date 2012-10-10
Name of individual signing BECKY KONG
SCOTIA-GLENVILLE FAMILY MEDICINE, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2010 141691508 2011-10-11 SCOTIA-GLENVILLE FAMILY MEDICINE, P.C. 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 5183997723
Plan sponsor’s address 112 CHARLTON ROAD, BALLSTON LAKE, NY, 12019

Plan administrator’s name and address
Administrator’s EIN 141691508
Plan administrator’s name SCOTIA-GLENVILLE FAMILY MEDICINE, P.C.
Plan administrator’s address 112 CHARLTON ROAD, BALLSTON LAKE, NY, 12019
Administrator’s telephone number 5183997723

Signature of
Role Plan administrator
Date 2011-10-11
Name of individual signing BECKY KONG
SCOTIA-GLENVILLE FAMILY MEDICINE, P.C. 401(K) PROFIT SHARING PLAN AND TRUST 2009 141691508 2010-09-13 SCOTIA-GLENVILLE FAMILY MEDICINE, P.C. 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 5183997723
Plan sponsor’s address 112 CHARLTON ROAD, BALLSTON LAKE, NY, 12019

Plan administrator’s name and address
Administrator’s EIN 141691508
Plan administrator’s name SCOTIA-GLENVILLE FAMILY MEDICINE, P.C.
Plan administrator’s address 112 CHARLTON ROAD, BALLSTON LAKE, NY, 12019
Administrator’s telephone number 5183997723

Signature of
Role Plan administrator
Date 2010-09-13
Name of individual signing BECKY KONG

Chief Executive Officer

Name Role Address
ROBERT HALBIG MD Chief Executive Officer 112 CHARLTON RD, BALLSTON LAKE, NY, United States, 12019

DOS Process Agent

Name Role Address
ROBERT HALBIG MD DOS Process Agent CHRISTOPHER BUFF DO, 112 CHARLTON RD, BALLSTON LAKE, NY, United States, 12019

History

Start date End date Type Value
1997-04-15 1999-02-05 Address 124 SARATOGA RD, SCOTIA, NY, 12302, USA (Type of address: Chief Executive Officer)
1997-04-15 1999-02-05 Address 124 SARATOGA RD, SCOTIA, NY, 12302, USA (Type of address: Principal Executive Office)
1992-05-15 1996-05-28 Name ROBERT HALBIG, M.D. & CHRISTOPHER BUFF, D.O., P.C.
1987-01-26 1992-05-15 Name ROBERT HALBIG, M.D. & JEFFREY HOLMSTROM, D.O., P.C.
1987-01-26 1999-02-05 Address JEFFREY HOMSTROM DO PC, 124 SARATOGA ROAD, SCOTIA, NY, 12302, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
150116006724 2015-01-16 BIENNIAL STATEMENT 2015-01-01
130117002183 2013-01-17 BIENNIAL STATEMENT 2013-01-01
110127003245 2011-01-27 BIENNIAL STATEMENT 2011-01-01
090114003055 2009-01-14 BIENNIAL STATEMENT 2009-01-01
061227002881 2006-12-27 BIENNIAL STATEMENT 2007-01-01
050201002253 2005-02-01 BIENNIAL STATEMENT 2005-01-01
021230002621 2002-12-30 BIENNIAL STATEMENT 2003-01-01
010102002069 2001-01-02 BIENNIAL STATEMENT 2001-01-01
990205002270 1999-02-05 BIENNIAL STATEMENT 1999-01-01
970415002140 1997-04-15 BIENNIAL STATEMENT 1997-01-01

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 06 Jan 2025

Sources: New York Secretary of State

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