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  5. LIEZL VILLAVERDE, M.D., P.C.

LIEZL VILLAVERDE, M.D., P.C.

Company Details

Name: LIEZL VILLAVERDE, M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 06 Apr 2001 (24 years ago)
Entity Number: 2625451
ZIP code: 10314
County: Richmond
Place of Formation: New York
Address: 105 BYRNE AVENUE, STATEN ISLAND, NY, United States, 10314
Principal Address: 105 BYRNE AVE, STATEN ISLAND, NY, United States, 10314

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
LIEZL VILLAVERDE, M.D., P.C. 401(K) PROFIT SHARING PLAN 2023 134166796 2024-05-29 LIEZL VILLAVERDE, M.D., P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 7186987220
Plan sponsor’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2024-05-29
Name of individual signing LIEZL VILLAVERDE
LIEZL VILLAVERDE, M.D., P.C. 401(K) PROFIT SHARING PLAN 2022 134166796 2023-05-08 LIEZL VILLAVERDE, M.D., P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 7186987220
Plan sponsor’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2023-05-05
Name of individual signing LIEZL VILLAVERDE
LIEZL VILLAVERDE, M.D., P.C. 401(K) PROFIT SHARING PLAN 2021 134166796 2022-03-31 LIEZL VILLAVERDE, M.D., P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 7186987220
Plan sponsor’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2022-03-30
Name of individual signing LIEZL VILLAVERDE
LIEZL VILLAVERDE, M.D., P.C. 401(K) PROFIT SHARING PLAN 2020 134166796 2021-05-04 LIEZL VILLAVERDE, M.D., P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 7186987220
Plan sponsor’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314

Plan administrator’s name and address
Administrator’s EIN 134166796
Plan administrator’s name LIEZL VILLAVERDE, M.D., P.C.
Plan administrator’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314
Administrator’s telephone number 7186987220

Signature of
Role Plan administrator
Date 2021-05-04
Name of individual signing LIEZL VILLAVERDE
LIEZL VILLAVERDE, M.D., P.C. 401(K) PROFIT SHARING PLAN 2019 134166796 2020-05-29 LIEZL VILLAVERDE, M.D., P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 7186987220
Plan sponsor’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314

Plan administrator’s name and address
Administrator’s EIN 134166796
Plan administrator’s name LIEZL VILLAVERDE, M.D., P.C.
Plan administrator’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314
Administrator’s telephone number 7186987220

Signature of
Role Plan administrator
Date 2020-05-29
Name of individual signing LIEZL VILLAVERDE
LIEZL VILLAVERDE, M.D., P.C. 401(K) PROFIT SHARING PLAN 2018 134166796 2019-04-10 LIEZL VILLAVERDE, M.D., P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 7186987220
Plan sponsor’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314

Plan administrator’s name and address
Administrator’s EIN 134166796
Plan administrator’s name LIEZL VILLAVERDE, M.D., P.C.
Plan administrator’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314
Administrator’s telephone number 7186987220

Signature of
Role Plan administrator
Date 2019-04-10
Name of individual signing LIEZL VILLAVERDE
LIEZL VILLAVERDE, M.D., P.C. 401(K) PROFIT SHARING PLAN 2017 134166796 2018-04-12 LIEZL VILLAVERDE, M.D., P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 7186987220
Plan sponsor’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314

Plan administrator’s name and address
Administrator’s EIN 134166796
Plan administrator’s name LIEZL VILLAVERDE, M.D., P.C.
Plan administrator’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314
Administrator’s telephone number 7186987220

Signature of
Role Plan administrator
Date 2018-04-11
Name of individual signing LIEZL VILLAVERDE
LIEZL VILLAVERDE, M.D., P.C. 401(K) PROFIT SHARING PLAN 2016 134166796 2017-03-24 LIEZL VILLAVERDE, M.D., P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 7186987220
Plan sponsor’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314

Plan administrator’s name and address
Administrator’s EIN 134166796
Plan administrator’s name LIEZL VILLAVERDE, M.D., P.C.
Plan administrator’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314
Administrator’s telephone number 7186987220

Signature of
Role Plan administrator
Date 2017-03-24
Name of individual signing LIEZL VILLAVERDE
LIEZL VILLAVERDE, M.D., P.C. 401(K) PROFIT SHARING PLAN 2015 134166796 2016-03-03 LIEZL VILLAVERDE, M.D., P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 7186987220
Plan sponsor’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314

Plan administrator’s name and address
Administrator’s EIN 134166796
Plan administrator’s name LIEZL VILLAVERDE, M.D., P.C.
Plan administrator’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314
Administrator’s telephone number 7186987220

Signature of
Role Plan administrator
Date 2016-03-02
Name of individual signing LIEZL VILLAVERDE
LIEZL VILLAVERDE, M.D., P.C. 401(K) PROFIT SHARING PLAN 2014 134166796 2015-04-14 LIEZL VILLAVERDE, M.D., P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 7186987220
Plan sponsor’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314

Plan administrator’s name and address
Administrator’s EIN 134166796
Plan administrator’s name LIEZL VILLAVERDE, M.D., P.C.
Plan administrator’s address 105 BYRNE AVENUE, STATEN ISLAND, NY, 10314
Administrator’s telephone number 7186987220

Signature of
Role Plan administrator
Date 2015-04-14
Name of individual signing LIEZL VILLAVERDE

Chief Executive Officer

Name Role Address
LIEZL VILLAVERDE MD Chief Executive Officer 105 BYRNE AVE, STATEN ISLAND, NY, United States, 10314

DOS Process Agent

Name Role Address
LIEZL VILLAVERDE MD DOS Process Agent 105 BYRNE AVENUE, STATEN ISLAND, NY, United States, 10314

History

Start date End date Type Value
2023-04-01 2023-04-01 Address 105 BYRNE AVE, STATEN ISLAND, NY, 10314, USA (Type of address: Chief Executive Officer)
2022-02-14 2023-04-01 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2003-04-11 2023-04-01 Address 105 BYRNE AVE, STATEN ISLAND, NY, 10314, USA (Type of address: Chief Executive Officer)
2003-04-11 2023-04-01 Address 35 TRISH CT, MATAWAN, NJ, 07747, USA (Type of address: Service of Process)
2001-04-06 2022-02-14 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2001-04-06 2003-04-11 Address 1514 RICHMOND AVENUE, STATEN ISLAND, NY, 10314, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
230401000339 2023-04-01 BIENNIAL STATEMENT 2023-04-01
220223000771 2022-02-23 BIENNIAL STATEMENT 2022-02-23
110509002474 2011-05-09 BIENNIAL STATEMENT 2011-04-01
090403002372 2009-04-03 BIENNIAL STATEMENT 2009-04-01
070705002564 2007-07-05 BIENNIAL STATEMENT 2007-04-01
050427002750 2005-04-27 BIENNIAL STATEMENT 2005-04-01
030411002457 2003-04-11 BIENNIAL STATEMENT 2003-04-01
010406000354 2001-04-06 CERTIFICATE OF INCORPORATION 2001-04-06

Related by officers

No related officers

Related by address

105 BYRNE AVE, STATEN ISLAND, NY, United States, 10314

BERNAD WU, M.D., P.C. E&L ASSOCIATES, LLC

Date of last update: 13 Mar 2025

Sources: New York Secretary of State

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