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  5. SOUTH SHORE AMBULATORY SURGERY CENTER, LLC

SOUTH SHORE AMBULATORY SURGERY CENTER, LLC

Company Details

Name: SOUTH SHORE AMBULATORY SURGERY CENTER, LLC
Jurisdiction: New York
Legal type: DOMESTIC LIMITED LIABILITY COMPANY
Status: Inactive
Date of registration: 08 Jun 2000 (25 years ago)
Date of dissolution: 05 Aug 2022
Entity Number: 2518971
ZIP code: 11563
County: Nassau
Place of Formation: New York
Address: 444 MERRICK RD, STE 400, LYNBROOK, NY, United States, 11563

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SSASC 401K RETIREMENT PLAN 2020 113556427 2021-07-28 SOUTH SHORE AMBULATORY SURGERY CENTER, LLC 81
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621493
Sponsor’s telephone number 5168870890
Plan sponsor’s address 444 MERRICK ROAD, SUITE 400, LYNBROOK, NY, 11563

Signature of
Role Plan administrator
Date 2021-07-28
Name of individual signing JAY RAIFMAN
SSASC 401K RETIREMENT PLAN 2019 113556427 2020-06-14 SOUTH SHORE AMBULATORY SURGERY CENTER, LLC 76
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621493
Sponsor’s telephone number 5168870890
Plan sponsor’s address 44 MERRICK ROAD, SUITE 400, LYNBROOK, NY, 11563

Signature of
Role Plan administrator
Date 2020-06-14
Name of individual signing JAY RAIFMAN
SSASC 401K RETIREMENT PLAN 2018 113556427 2019-08-22 SOUTH SHORE AMBULATORY SURGERY CENTER, LLC 66
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621493
Sponsor’s telephone number 5168870890
Plan sponsor’s address 44 MERRICK ROAD, SUITE 400, LYNBROOK, NY, 11563

Signature of
Role Plan administrator
Date 2019-08-22
Name of individual signing JAY RAIFMAN
SSASC 401K RETIREMENT PLAN 2017 113556427 2018-06-04 SOUTH SHORE AMBULATORY SURGERY CENTER, LLC 64
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621493
Sponsor’s telephone number 5168870890
Plan sponsor’s address 44 MERRICK ROAD, SUITE 400, LYNBROOK, NY, 11563

Signature of
Role Plan administrator
Date 2018-06-04
Name of individual signing JAY RAIFMAN
SSASC 401K RETIREMENT PLAN 2016 113556427 2017-08-09 SOUTH SHORE AMBULATORY SURGERY CENTER, LLC 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621493
Sponsor’s telephone number 5168870890
Plan sponsor’s address 44 MERRICK ROAD, SUITE 400, LYNBROOK, NY, 11563

Signature of
Role Plan administrator
Date 2017-08-09
Name of individual signing JAY RAIFMAN
SSASC 401K RETIREMENT PLAN 2015 113556427 2016-07-11 SOUTH SHORE AMBULATORY SURGERY CENTER, LLC 57
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621493
Sponsor’s telephone number 5168870890
Plan sponsor’s address 44 MERRICK ROAD, SUITE 400, LYNBROOK, NY, 11563

Signature of
Role Plan administrator
Date 2016-07-11
Name of individual signing JAY RAIFMAN
SSASC 401K RETIREMENT PLAN 2014 113556427 2015-07-20 SOUTH SHORE AMBULATORY SURGERY CENTER, LLC 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621493
Sponsor’s telephone number 5168870890
Plan sponsor’s address 44 MERRICK ROAD, SUITE 400, LYNBROOK, NY, 11563

Signature of
Role Plan administrator
Date 2015-07-20
Name of individual signing DEBRA HAGENDORN

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 444 MERRICK RD, STE 400, LYNBROOK, NY, United States, 11563

History

Start date End date Type Value
2012-07-26 2022-08-05 Address 444 MERRICK RD, STE 400, LYNBROOK, NY, 11563, USA (Type of address: Service of Process)
2006-06-27 2012-07-26 Address 444 MERRICK RD, STE 400, LYNBROOK, NY, 11563, USA (Type of address: Service of Process)
2000-06-08 2006-06-27 Address 444 MERRICK ROAD, LYNBROOK, NY, 11563, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
220805001621 2022-05-10 CERTIFICATE OF DISSOLUTION-CANCELLATION 2022-05-10
210902001006 2021-09-02 BIENNIAL STATEMENT 2021-09-02
140612006562 2014-06-12 BIENNIAL STATEMENT 2014-06-01
120726002204 2012-07-26 BIENNIAL STATEMENT 2012-06-01
100709002703 2010-07-09 BIENNIAL STATEMENT 2010-06-01
080620002586 2008-06-20 BIENNIAL STATEMENT 2008-06-01
060627002214 2006-06-27 BIENNIAL STATEMENT 2006-06-01
040716002446 2004-07-16 BIENNIAL STATEMENT 2004-06-01
020211001023 2002-02-11 CERTIFICATE OF AMENDMENT 2002-02-11
000828000438 2000-08-28 AFFIDAVIT OF PUBLICATION 2000-08-28

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1355578600 2021-03-13 0235 PPS 444 Merrick Rd # 4, Lynbrook, NY, 11563-2460
Loan Status Date 2021-10-16
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 550570
Loan Approval Amount (current) 550570
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Lynbrook, NASSAU, NY, 11563-2460
Project Congressional District NY-04
Number of Employees 52
NAICS code 621493
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 553270.06
Forgiveness Paid Date 2021-09-10

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Date of last update: 30 Mar 2025

Sources: New York Secretary of State

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