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  5. ADIRONDACK INTERVENTIONAL PHYSIATRY, P.C.

ADIRONDACK INTERVENTIONAL PHYSIATRY, P.C.

Company Details

Name: ADIRONDACK INTERVENTIONAL PHYSIATRY, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 10 Aug 2004 (21 years ago)
Entity Number: 3088778
ZIP code: 12901
County: Clinton
Place of Formation: New York
Address: 64 STAFFORD DRIVE, PLATTSBURGH, NY, United States, 12901
Principal Address: 4 FEATHER DRIVE, PLATTSBURGH, NY, United States, 12901

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
CHAMPLAIN SPINE AND PAIN MANAGEMENT RETIREMENT PLAN 2022 510514639 2024-07-15 ADIRONDACK INTERVENTIONAL, PHYSIATRY, P.C. 53
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-10-01
Business code 621111
Sponsor’s telephone number 5183247246
Plan sponsor’s address 294 TOM MILLER ROAD, PLATTSBURGH, NY, 12901
CHAMPLAIN SPINE AND PAIN MANAGEMENT 401(K) PROFIT SHARING PLAN 2022 510514639 2024-07-15 ADIRONDACK INTERVENTIONAL PHYSIATRY, P.C. 74
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-10-01
Business code 621111
Sponsor’s telephone number 5183247246
Plan sponsor’s address 294 TOM MILLER ROAD, PLATTSBURGH, NY, 12901

Signature of
Role Plan administrator
Date 2024-07-15
Name of individual signing THIERRY BONNABESSE
Role Employer/plan sponsor
Date 2024-07-15
Name of individual signing THIERRY BONNABESSE
CHAMPLAIN SPINE AND PAIN MANAGEMENT 401(K) PROFIT SHARING PLAN 2021 510514639 2023-07-14 ADIRONDACK INTERVENTIONAL PHYSIATRY, P.C. 57
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-10-01
Business code 621111
Sponsor’s telephone number 5183247246
Plan sponsor’s address 294 TOM MILLER ROAD, PLATTSBURGH, NY, 12901

Signature of
Role Plan administrator
Date 2023-07-14
Name of individual signing THIERRY BONNABESSE
Role Employer/plan sponsor
Date 2023-07-14
Name of individual signing THIERRY BONNABESSE
CHAMPLAIN SPINE AND PAIN MANAGEMENT RETIREMENT PLAN 2021 510514639 2023-07-14 ADIRONDACK INTERVENTIONAL , PHYSIATRY, P.C. 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-10-01
Business code 621111
Sponsor’s telephone number 5183247246
Plan sponsor’s address 294 TOM MILLER ROAD, PLATTSBURGH, NY, 12901
CHAMPLAIN SPINE AND PAIN MANAGEMENT 401(K) PROFIT SHARING PLAN 2020 510514639 2022-07-13 ADIRONDACK INTERVENTIONAL PHYSIATRY, P.C. 54
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-10-01
Business code 621111
Sponsor’s telephone number 5183247246
Plan sponsor’s address 294 TOM MILLER ROAD, PLATTSBURGH, NY, 12901

Signature of
Role Plan administrator
Date 2022-07-13
Name of individual signing THIERRY BONNABESSE
Role Employer/plan sponsor
Date 2022-07-13
Name of individual signing THIERRY BONNABESSE
CHAMPLAIN SPINE AND PAIN MANAGEMENT RETIREMENT PLAN 2020 510514639 2022-07-14 ADIRONDACK INTERVENTIONAL , PHYSIATRY, P.C. 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-10-01
Business code 621111
Sponsor’s telephone number 5183247246
Plan sponsor’s address 294 TOM MILLER ROAD, PLATTSBURGH, NY, 12901
CHAMPLAIN SPINE AND PAIN MANAGEMENT RETIREMENT PLAN 2019 510514639 2021-06-17 ADIRONDACK INTERVENTIONAL , PHYSIATRY, P.C. 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-10-01
Business code 621111
Sponsor’s telephone number 5183247246
Plan sponsor’s address 294 TOM MILLER ROAD, PLATTSBURGH, NY, 12901
CHAMPLAIN SPINE AND PAIN MANAGEMENT 401(K) PROFIT SHARING PLAN 2019 510514639 2021-07-15 ADIRONDACK INTERVENTIONAL PHYSIATRY, P.C. 55
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-10-01
Business code 621111
Sponsor’s telephone number 5183247246
Plan sponsor’s address 294 TOM MILLER ROAD, PLATTSBURGH, NY, 12901

Signature of
Role Plan administrator
Date 2021-07-15
Name of individual signing THIERRY BONNABESSE
Role Employer/plan sponsor
Date 2021-07-15
Name of individual signing THIERRY BONNABESSE
CHAMPLAIN SPINE AND PAIN MANAGEMENT 401(K) PROFIT SHARING PLAN 2018 510514639 2020-07-15 ADIRONDACK INTERVENTIONAL PHYSIATRY, P.C. 50
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-10-01
Business code 621111
Sponsor’s telephone number 5183247246
Plan sponsor’s address 294 TOM MILLER ROAD, PLATTSBURGH, NY, 12901

Signature of
Role Plan administrator
Date 2020-07-15
Name of individual signing THIERRY BONNABESSE
Role Employer/plan sponsor
Date 2020-07-15
Name of individual signing THIERRY BONNABESSE
CHAMPLAIN SPINE AND PAIN MANAGEMENT RETIREMENT PLAN 2018 510514639 2020-07-15 ADIRONDACK INTERVENTIONAL PHYSIATRY, P.C. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-10-01
Business code 621111
Sponsor’s telephone number 5183247246
Plan sponsor’s address 294 TOM MILLER ROAD, PLATTSBURGH, NY, 12901

DOS Process Agent

Name Role Address
C/O THIERRY BONNABESSE DOS Process Agent 64 STAFFORD DRIVE, PLATTSBURGH, NY, United States, 12901

Chief Executive Officer

Name Role Address
THIERRY BONNABESSE Chief Executive Officer 4 FEATHER DRIVE, PLATTSBURGH, NY, United States, 12901

History

Start date End date Type Value
2018-08-01 2020-08-03 Address 64 STAFFORD DRIVE, PLATTSBURGH, NY, 12901, USA (Type of address: Service of Process)
2017-12-26 2018-08-01 Address 64 STAFFORD DR, PLATTSBURGH, NY, 12901, USA (Type of address: Service of Process)
2010-09-21 2017-12-26 Address 4 FEATHER DRIVE, PLATTSBURGH, NY, 12901, USA (Type of address: Service of Process)
2006-09-21 2010-09-21 Address 64 STAFFORD DRIVE, PLATTSBURGH, NY, 12901, USA (Type of address: Principal Executive Office)
2006-09-21 2010-09-21 Address 85 PLAZA BLVD STE 102, PLATTSBURGH, NY, 12901, USA (Type of address: Chief Executive Officer)
2004-08-10 2010-09-21 Address 85 PLAZA BLVD., SUITE 102, PLATTSBURGH, NY, 12901, USA (Type of address: Service of Process)
2004-08-10 2023-10-27 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
200803061557 2020-08-03 BIENNIAL STATEMENT 2020-08-01
180801006688 2018-08-01 BIENNIAL STATEMENT 2018-08-01
171226006079 2017-12-26 BIENNIAL STATEMENT 2016-08-01
140818006451 2014-08-18 BIENNIAL STATEMENT 2014-08-01
120822002961 2012-08-22 BIENNIAL STATEMENT 2012-08-01
100921002168 2010-09-21 BIENNIAL STATEMENT 2010-08-01
080820002462 2008-08-20 BIENNIAL STATEMENT 2008-08-01
060921002463 2006-09-21 BIENNIAL STATEMENT 2006-08-01
040810000451 2004-08-10 CERTIFICATE OF INCORPORATION 2004-08-10

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5239347410 2020-05-12 0248 PPP 4 Feather Drive, PLATTSBURGH, NY, 12901-6461
Loan Status Date 2021-10-09
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 437000
Loan Approval Amount (current) 461200
Undisbursed Amount 0
Franchise Name -
Lender Location ID 47268
Servicing Lender Name Glens Falls National Bank and Trust Company
Servicing Lender Address 250 Glen St, GLENS FALLS, NY, 12801-3505
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address PLATTSBURGH, CLINTON, NY, 12901-6461
Project Congressional District NY-21
Number of Employees 47
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 47268
Originating Lender Name Glens Falls National Bank and Trust Company
Originating Lender Address GLENS FALLS, NY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 466977.81
Forgiveness Paid Date 2021-08-17

Related by officers

THIERRY BONNABESSE

TNS REALTY LLC

Related by address

64 STAFFORD DRIVE, PLATTSBURGH, NY, United States, 12901

TNS REALTY LLC

Date of last update: 29 Mar 2025

Sources: New York Secretary of State

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