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  5. PREMIER MEDICAL PLLC

PREMIER MEDICAL PLLC

Company Details

Name: PREMIER MEDICAL PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 24 Sep 2002 (23 years ago)
Entity Number: 2815427
ZIP code: 10306
County: Richmond
Place of Formation: New York
Address: 1975 HYLAN BLVD., STATEN ISLAND, NY, United States, 10306

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PREMIER MEDICAL PLLC RETIREMENT PLAN 2023 223871742 2024-09-23 PREMIER MEDICAL, PLLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314
PREMIER MEDICAL, PLLC CASH BALANCE PLAN 2023 223871742 2024-09-23 PREMIER MEDICAL, PLLC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314
PREMIER MEDICAL, PLLC CASH BALANCE PLAN 2022 223871742 2023-09-05 PREMIER MEDICAL, PLLC 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2023-09-05
Name of individual signing JEFFRY TAMBOR
PREMIER MEDICAL PLLC RETIREMENT PLAN 2022 223871742 2023-09-05 PREMIER MEDICAL, PLLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2023-09-05
Name of individual signing JEFFRY TAMBOR
PREMIER MEDICAL, PLLC CASH BALANCE PLAN 2021 223871742 2022-09-06 PREMIER MEDICAL, PLLC 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2022-09-06
Name of individual signing JEFFRY TAMBOR
PREMIER MEDICAL PLLC RETIREMENT PLAN 2021 223871742 2022-09-06 PREMIER MEDICAL, PLLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2022-09-06
Name of individual signing JEFFRY TAMBOR
PREMIER MEDICAL PLLC RETIREMENT PLAN 2020 223871742 2021-09-13 PREMIER MEDICAL, PLLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2021-09-13
Name of individual signing JEFFRY TAMBOR
PREMIER MEDICAL, PLLC CASH BALANCE PLAN 2020 223871742 2021-09-13 PREMIER MEDICAL, PLLC 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2021-09-13
Name of individual signing JEFFRY TAMBOR
PREMIER MEDICAL PLLC RETIREMENT PLAN 2019 223871742 2020-10-02 PREMIER MEDICAL, PLLC 17
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2020-10-02
Name of individual signing JEFFRY TAMBOR
PREMIER MEDICAL, PLLC CASH BALANCE PLAN 2019 223871742 2020-10-02 PREMIER MEDICAL, PLLC 13
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 7189795880
Plan sponsor’s address PO BOX 141296, STATEN ISLAND, NY, 10314

Signature of
Role Plan administrator
Date 2020-10-02
Name of individual signing JEFFRY TAMBOR

DOS Process Agent

Name Role Address
JEFFREY TAMBOR, M.D. DOS Process Agent 1975 HYLAN BLVD., STATEN ISLAND, NY, United States, 10306

Filings

Filing Number Date Filed Type Effective Date
080827002321 2008-08-27 BIENNIAL STATEMENT 2008-09-01
060906002365 2006-09-06 BIENNIAL STATEMENT 2006-09-01
020924000770 2002-09-24 ARTICLES OF ORGANIZATION 2002-09-24

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
4096957206 2020-04-27 0202 PPP PO BOX 141296, PO, NY, 10314-1296
Loan Status Date 2021-02-06
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 39100
Loan Approval Amount (current) 39100
Undisbursed Amount 0
Franchise Name -
Lender Location ID 89027
Servicing Lender Name Northfield Bank
Servicing Lender Address 581 Main Street, Suite 810, Woodbridge, NJ, 07095
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address PO, RICHMOND, NY, 10314-1296
Project Congressional District NY-11
Number of Employees 9
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Partnership
Originating Lender ID 122496
Originating Lender Name Northfield Bank
Originating Lender Address NEW YORK CITY, NY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 39377.45
Forgiveness Paid Date 2021-01-13

Related by officers

No related officers

Related by address

1975 HYLAN BLVD., STATEN ISLAND, NY, United States, 10306

INN BY THE WAYSIDE PARACHUTE CLUB, INC. RRC ACCOUNT MANAGEMENT CORP. 1975 HYLAN BLVD. CORP. SUNRISE MEDICAL PRACTICE P.C. INN BY THE WAYSIDE INC.

Date of last update: 30 Mar 2025

Sources: New York Secretary of State

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