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  5. ISLAND DERMATOLOGY, P.C.

ISLAND DERMATOLOGY, P.C.

Company Details

Name: ISLAND DERMATOLOGY, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 07 Jul 1992 (33 years ago)
Entity Number: 1649841
ZIP code: 11561
County: New York
Place of Formation: New York
Address: 38 PRESCOTT STREET, LIDO BEACH, NY, United States, 11561

Contact Details

Phone +1 631-598-5373

Phone +1 516-432-0011

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
ISLAND DERMATOLOGY, P.C. 401(K) PROFIT SHARING PLAN 2017 113114920 2018-09-25 ISLAND DERMATOLOGY, P.C. 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 5164320011
Plan sponsor’s address 604 EAST PARK AVENUE, LONG BEACH, NY, 11561
CREATED FROM ISLAND DERMATOLOGY, P.C. 401(K) PROFIT SHARING PLAN 2017 113114920 2018-09-25 ISLAND DERMATOLOGY, P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 5164320011
Plan sponsor’s address 604 EAST PARK AVENUE, LONG BEACH, NY, 11561
ISLAND DERMATOLOGY, P.C. 401(K) PROFIT SHARING PLAN 2016 113114920 2017-09-20 ISLAND DERMATOLOGY, P.C. 46
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 5164320011
Plan sponsor’s address 604 EAST PARK AVENUE, LONG BEACH, NY, 11561
ISLAND DERMATOLOGY, P.C. 401(K) PROFIT SHARING PLAN 2015 113114920 2016-06-29 ISLAND DERMATOLOGY, P.C. 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 5164320011
Plan sponsor’s address 604 EAST PARK AVENUE, LONG BEACH, NY, 11561

Signature of
Role Plan administrator
Date 2016-06-28
Name of individual signing RONALD FALCON
Role Employer/plan sponsor
Date 2016-06-28
Name of individual signing RONALD FALCON
ISLAND DERMATOLOGY, P.C. 401(K) PROFIT SHARING PLAN 2014 113114920 2015-07-16 ISLAND DERMATOLOGY, P.C. 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 5164320011
Plan sponsor’s address 604 EAST PARK AVENUE, LONG BEACH, NY, 11561

Signature of
Role Plan administrator
Date 2015-06-02
Name of individual signing RONAD FALCON
Role Employer/plan sponsor
Date 2015-06-02
Name of individual signing RONAD FALCON
ISLAND DERMATOLOGY, P.C. 401(K) PROFIT SHARING PLAN 2013 113114920 2014-05-27 ISLAND DERMATOLOGY, P.C. 44
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 5164320011
Plan sponsor’s address 604 EAST PARK AVENUE, LONG BEACH, NY, 11561

Signature of
Role Plan administrator
Date 2014-05-21
Name of individual signing RONALD FALCON
Role Employer/plan sponsor
Date 2014-05-21
Name of individual signing RONALD FALCON
ISLAND DERMATOLOGY, P.C. 401(K) PROFIT SHARING PLAN 2012 113114920 2013-07-15 ISLAND DERMATOLOGY, P.C. 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 5164320011
Plan sponsor’s address 604 EAST PARK AVENUE, LONG BEACH, NY, 11561

Signature of
Role Plan administrator
Date 2013-07-03
Name of individual signing RONALD FALCON
Role Employer/plan sponsor
Date 2013-07-03
Name of individual signing RONALD FALCON
ISLAND DERMATOLOGY, P.C. 401(K) PROFIT SHARING PLAN 2011 113114920 2012-07-25 ISLAND DERMATOLOGY, P.C. 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 5164320011
Plan sponsor’s address 604 EAST PARK AVENUE, LONG BEACH, NY, 11561

Plan administrator’s name and address
Administrator’s EIN 113114920
Plan administrator’s name ISLAND DERMATOLOGY, P.C.
Plan administrator’s address 604 EAST PARK AVENUE, LONG BEACH, NY, 11561
Administrator’s telephone number 5164320011

Signature of
Role Plan administrator
Date 2012-07-21
Name of individual signing RONALD FALCON
Role Employer/plan sponsor
Date 2012-07-21
Name of individual signing RONALD FALCON
ISLAND DERMATOLOGY, P.C. 401(K) PROFIT SHARING PLAN 2010 113114920 2011-06-14 ISLAND DERMATOLOGY, P.C. 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 5164320011
Plan sponsor’s address 604 EAST PARK AVENUE, LONG BEACH, NY, 11561

Plan administrator’s name and address
Administrator’s EIN 113114920
Plan administrator’s name ISLAND DERMATOLOGY, P.C.
Plan administrator’s address 604 EAST PARK AVENUE, LONG BEACH, NY, 11561
Administrator’s telephone number 5164320011

Signature of
Role Plan administrator
Date 2011-06-14
Name of individual signing RONALD FALCON
Role Employer/plan sponsor
Date 2011-06-14
Name of individual signing RONALD FALCON
ISLAND DERMATOLOGY, P.C. 401(K) PROFIT SHARING PLAN 2009 113114920 2010-10-11 ISLAND DERMATOLOGY, P.C. 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 5164320011
Plan sponsor’s address 604 EAST PARK AVENUE, LONG BEACH, NY, 11561

Plan administrator’s name and address
Administrator’s EIN 113114920
Plan administrator’s name ISLAND DERMATOLOGY, P.C.
Plan administrator’s address 604 EAST PARK AVENUE, LONG BEACH, NY, 11561
Administrator’s telephone number 5164320011

Signature of
Role Plan administrator
Date 2010-10-10
Name of individual signing RONALD FALCON
Role Employer/plan sponsor
Date 2010-10-10
Name of individual signing RONALD FALCON

DOS Process Agent

Name Role Address
RONALD H FALCON DOS Process Agent 38 PRESCOTT STREET, LIDO BEACH, NY, United States, 11561

Chief Executive Officer

Name Role Address
RONALD H FALCON Chief Executive Officer 38 PRESCOTT STREET, LIDO BEACH, NY, United States, 11561

History

Start date End date Type Value
1996-07-17 2020-08-03 Address 604 EAST PARK AVE, LONG BEACH, NY, 11561, 2505, USA (Type of address: Chief Executive Officer)
1996-07-17 2020-08-03 Address 604 EAST PARK AVE, LONG BEACH, NY, 11561, 2505, USA (Type of address: Service of Process)
1993-08-12 1996-07-17 Address 604 EAST PARK AVENUE, LONG BEACH, NY, 11561, USA (Type of address: Chief Executive Officer)
1993-08-12 1996-07-17 Address 604 EAST PARK AVENUE, LONG BEACH, NY, 11561, USA (Type of address: Principal Executive Office)
1993-08-12 1996-07-17 Address 604 EAT PARK AVENUE, LONG BEACH, NY, 11561, USA (Type of address: Service of Process)
1992-07-07 1993-08-12 Address 300 OLD COUNTRY ROAD, MINEOLA, NY, 11501, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
200803060940 2020-08-03 BIENNIAL STATEMENT 2020-07-01
180703007646 2018-07-03 BIENNIAL STATEMENT 2018-07-01
160713006293 2016-07-13 BIENNIAL STATEMENT 2016-07-01
140731006319 2014-07-31 BIENNIAL STATEMENT 2014-07-01
120801002401 2012-08-01 BIENNIAL STATEMENT 2012-07-01
100715002167 2010-07-15 BIENNIAL STATEMENT 2010-07-01
080722003267 2008-07-22 BIENNIAL STATEMENT 2008-07-01
060616002341 2006-06-16 BIENNIAL STATEMENT 2006-07-01
040727002648 2004-07-27 BIENNIAL STATEMENT 2004-07-01
020618002367 2002-06-18 BIENNIAL STATEMENT 2002-07-01

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 04 Jan 2025

Sources: New York Secretary of State

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