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  5. JOHN M. SIMON, M.D., P.C.

JOHN M. SIMON, M.D., P.C.

Company Details

Name: JOHN M. SIMON, M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 22 Jul 1988 (36 years ago)
Entity Number: 1279353
ZIP code: 11706
County: Suffolk
Place of Formation: New York
Address: 270 EAST MAIN STREET, BAY SHORE, NY, United States, 11706

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
JOHN M. SIMON, M.D., P.C. CASH BALANCE PLAN 2016 112910248 2017-10-23 JOHN M. SIMON, M.D., P.C. 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 6313216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795
JOHN M. SIMON, M.D., P.C. CASH BALANCE PLAN 2016 112910248 2017-10-12 JOHN M. SIMON, M.D., P.C. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 6313216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795
JOHN M. SIMON, M.D., P.C. CASH BALANCE PLAN 2015 112910248 2016-10-14 JOHN M. SIMON, M.D., P.C. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 6313216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795
JOHN M. SIMON, M.D., P.C. 401(K) PLAN 2015 112910248 2016-10-14 JOHN M. SIMON, M.D., P.C. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 6313216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795
JOHN M. SIMON, M.D., P.C. CASH BALANCE PLAN 2014 112910248 2015-10-15 JOHN M. SIMON, M.D., P.C. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 6313216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2015-10-15
Name of individual signing CHRISTOPHER MARADIE
JOHN M. SIMON, M.D., P.C. 401(K) PLAN 2014 112910248 2015-07-28 JOHN M. SIMON, M.D., P.C. 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 6313216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2015-07-28
Name of individual signing CHRISTOPHER MARADIE
JOHN M. SIMON, M.D., P.C. CASH BALANCE PLAN 2013 112910248 2014-09-02 JOHN M. SIMON, M.D., P.C. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 6313216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2014-09-02
Name of individual signing CHRISTOPHER MARADIE
JOHN M. SIMON, M.D., P.C. 401(K) PLAN 2013 112910248 2014-04-11 JOHN M. SIMON, M.D., P.C. 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 6313216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2014-04-11
Name of individual signing CHRISTOPHER MARADIE
JOHN M. SIMON, M.D., P.C. 401(K) PLAN 2012 112910248 2014-04-10 JOHN M. SIMON, M.D., P.C. 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 6213216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2014-04-10
Name of individual signing CHRISTOPHER MARADIE
JOHN M. SIMON, M.D., P.C. CASH BALANCE PLAN 2012 112910248 2013-10-14 JOHN M. SIMON, M.D., P.C. 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 6213216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing CHRISTOPHER MARADIE

DOS Process Agent

Name Role Address
JOHN M. SIMON, PHYSICIAN, P.C. DOS Process Agent 270 EAST MAIN STREET, BAY SHORE, NY, United States, 11706

Filings

Filing Number Date Filed Type Effective Date
080728000789 2008-07-28 CERTIFICATE OF AMENDMENT 2008-07-28
B665979-4 1988-07-22 CERTIFICATE OF INCORPORATION 1988-07-22

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 05 Jan 2025

Sources: New York Secretary of State

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