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  5. MICHAEL NISSEN, M.D., P.C.

MICHAEL NISSEN, M.D., P.C.

Company Details

Name: MICHAEL NISSEN, M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 07 Jun 2001 (24 years ago)
Entity Number: 2647614
ZIP code: 10547
County: New York
Place of Formation: New York
Address: GARY M REING ESQ, 1360 SUNNY RIDGE ROAD, MOHEGAN LAKE, NY, United States, 10547
Principal Address: 225 EAST 64TH ST, NEW YORK, NY, United States, 10021

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
MICHAEL NISSEN, M.D., P.C. RETIREMENT PLAN 2023 134174737 2024-10-14 MICHAEL NISSEN, M.D., P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2127727000
Plan sponsor’s address 1317 3RD AVENUE, GROUND FLOOR, NEW YORK, NY, 100212995

Signature of
Role Plan administrator
Date 2024-10-12
Name of individual signing MICHAEL NISSEN
Valid signature Filed with authorized/valid electronic signature
MICHAEL NISSEN, M.D., P.C. RETIREMENT PLAN 2022 134174737 2023-08-23 MICHAEL NISSEN, M.D., P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2127727000
Plan sponsor’s address 1317 3RD AVENUE, GROUND FLOOR, NEW YORK, NY, 100212995

Signature of
Role Plan administrator
Date 2023-08-22
Name of individual signing MICHAEL NISSEN
MICHAEL NISSEN, M.D., P.C. RETIREMENT PLAN 2021 134174737 2022-10-17 MICHAEL NISSEN, M.D., P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2127727000
Plan sponsor’s address 1317 3RD AVENUE, GROUND FLOOR, NEW YORK, NY, 100212995

Signature of
Role Plan administrator
Date 2022-10-17
Name of individual signing MICHAEL NISSEN
MICHAEL NISSEN, M.D., P.C. RETIREMENT PLAN 2020 134174737 2021-06-01 MICHAEL NISSEN, M.D., P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2127727000
Plan sponsor’s address 1317 3RD AVENUE, GROUND FLOOR, NEW YORK, NY, 100212995

Signature of
Role Plan administrator
Date 2021-05-22
Name of individual signing MICHAEL NISSEN
Role Employer/plan sponsor
Date 2021-05-22
Name of individual signing MICHAEL NISSEN
MICHAEL NISSEN, M.D., P.C. RETIREMENT PLAN 2019 134174737 2020-06-05 MICHAEL NISSEN, M.D., P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2127727000
Plan sponsor’s address 1317 3RD AVENUE, GROUND FLOOR, NEW YORK, NY, 100212995

Signature of
Role Plan administrator
Date 2020-06-05
Name of individual signing MICHAEL NISSEN
MICHAEL NISSEN, M.D., P.C. RETIREMENT PLAN 2018 134174737 2019-10-02 MICHAEL NISSEN, M.D., P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2127727000
Plan sponsor’s address 1317 3RD AVENUE, GROUND FLOOR, NEW YORK, NY, 100212995

Signature of
Role Plan administrator
Date 2019-10-02
Name of individual signing MICHAEL NISSEN
Role Employer/plan sponsor
Date 2019-08-22
Name of individual signing MICHAEL NISSEN
MICHAEL NISSEN, M.D., P.C. RETIREMENT PLAN 2017 134174737 2018-10-15 MICHAEL NISSEN, M.D., P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2127727000
Plan sponsor’s address 1317 3RD AVENUE, GROUND FLOOR, NEW YORK, NY, 100212995

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing MICHAEL NISSEN
MICHAEL NISSEN, M.D., P.C. RETIREMENT PLAN 2016 134174737 2017-10-12 MICHAEL NISSEN, M.D., P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2127727000
Plan sponsor’s address 1317 3RD AVENUE, GROUND FLOOR, NEW YORK, NY, 100212995

Signature of
Role Plan administrator
Date 2017-10-12
Name of individual signing MICHAEL NISSEN
MICHAEL NISSEN, M.D., P.C. RETIREMENT PLAN 2015 134174737 2016-09-08 MICHAEL NISSEN, M.D., P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2127727000
Plan sponsor’s address 1317 3RD AVENUE, NEW YORK, NY, 100212995

Signature of
Role Plan administrator
Date 2016-09-08
Name of individual signing MICHAEL NISSEN
MICHAEL NISSEN, M.D., P.C. RETIREMENT PLAN 2014 134174737 2015-06-22 MICHAEL NISSEN, M.D., P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2127727000
Plan sponsor’s address 1317 3RD AVENUE, GROUND FLOOR, NEW YORK, NY, 100212995

Signature of
Role Plan administrator
Date 2015-06-22
Name of individual signing MICHAEL NISSEN

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent GARY M REING ESQ, 1360 SUNNY RIDGE ROAD, MOHEGAN LAKE, NY, United States, 10547

Chief Executive Officer

Name Role Address
MICHAEL NISSEN Chief Executive Officer 225 EAST 64TH ST, NEW YORK, NY, United States, 10021

Filings

Filing Number Date Filed Type Effective Date
070709002069 2007-07-09 BIENNIAL STATEMENT 2007-06-01
050901002431 2005-09-01 BIENNIAL STATEMENT 2005-06-01
030619002087 2003-06-19 BIENNIAL STATEMENT 2003-06-01
010607000066 2001-06-07 CERTIFICATE OF INCORPORATION 2001-06-07

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
6255058309 2021-01-26 0202 PPS 1317 3rd Ave, New York, NY, 10021-2995
Loan Status Date 2021-11-18
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 101992
Loan Approval Amount (current) 101992
Undisbursed Amount 0
Franchise Name -
Lender Location ID 48270
Servicing Lender Name JPMorgan Chase Bank, National Association
Servicing Lender Address 1111 Polaris Pkwy, COLUMBUS, OH, 43240-2031
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address New York, NEW YORK, NY, 10021-2995
Project Congressional District NY-12
Number of Employees 6
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 48270
Originating Lender Name JPMorgan Chase Bank, National Association
Originating Lender Address COLUMBUS, OH
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 102733.31
Forgiveness Paid Date 2021-10-25
3672557100 2020-04-11 0202 PPP 1317 3rd Avenue, New York, NY, 10021
Loan Status Date 2021-04-22
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 97495
Loan Approval Amount (current) 97495
Undisbursed Amount 0
Franchise Name -
Lender Location ID 48270
Servicing Lender Name JPMorgan Chase Bank, National Association
Servicing Lender Address 1111 Polaris Pkwy, COLUMBUS, OH, 43240-2031
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address New York, NEW YORK, NY, 10021-0001
Project Congressional District NY-12
Number of Employees 6
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 194093
Originating Lender Name JPMorgan Chase Bank, National Association
Originating Lender Address CHICAGO, IL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 98402.68
Forgiveness Paid Date 2021-03-23

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Related by address

225 EAST 64TH ST, NEW YORK, NY, United States, 10021

PAUL V. PORCELLI, D.P.M., P.C. WOMEN'S CARE-EASTSIDE MEDICAL SERVICES, P.C.

Date of last update: 30 Mar 2025

Sources: New York Secretary of State

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