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  5. JEFFREY M. NAKHJAVAN, DO, P.C.

JEFFREY M. NAKHJAVAN, DO, P.C.

Company Details

Name: JEFFREY M. NAKHJAVAN, DO, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 12 Apr 2006 (19 years ago)
Entity Number: 3347895
ZIP code: 11746
County: Suffolk
Place of Formation: New York
Address: JEFFREY M. NAKHJAVAN, DO, 4 FOX HOLLOW COURT, DIX HILLS, NY, United States, 11746

Contact Details

Phone +1 631-376-3000

Phone +1 631-242-1181

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
JEFFREY M. NAKHJAVAN, DO, P.C. 401(K) PLAN 2023 204693555 2024-10-15 JEFFREY M. NAKHJAVAN, DO, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6313921916
Plan sponsor’s mailing address 4 FOX HOLLOW COURT, DIX HILLS, NY, 11746
Plan sponsor’s address 760 SUNRISE HIGHWAY, WEST BABYLON, NY, 11704

Number of participants as of the end of the plan year
Active participants 14
Other retired or separated participants entitled to future benefits 4
Number of participants with account balances as of the end of the plan year 11

Signature of
Role Plan administrator
Date 2024-10-15
Name of individual signing JEFFREY NAKHJAVAN
Valid signature Filed with authorized/valid electronic signature
JEFFREY M. NAKHJAVAN, DO, P.C. 401(K) PLAN 2022 204693555 2023-08-30 JEFFREY M. NAKHJAVAN, DO, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6313921916
Plan sponsor’s mailing address 4 FOX HOLLOW COURT, DIX HILLS, NY, 11746
Plan sponsor’s address 760 SUNRISE HIGHWAY, WEST BABYLON, NY, 11704

Number of participants as of the end of the plan year
Active participants 7
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 4
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 11
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2023-08-30
Name of individual signing JEFFREY NAKHJAVAN
Valid signature Filed with authorized/valid electronic signature
JEFFREY M. NAKHJAVAN, DO, P.C. 401(K) PLAN 2021 204693555 2022-06-10 JEFFREY M. NAKHJAVAN, DO, P.C. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6313921916
Plan sponsor’s mailing address 4 FOX HOLLOW COURT, DIX HILLS, NY, 11746
Plan sponsor’s address 760 SUNRISE HIGHWAY, WEST BABYLON, NY, 11704

Number of participants as of the end of the plan year
Active participants 9
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 3
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 11
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2022-06-10
Name of individual signing JEFFREY NAKHJAVAN
Valid signature Filed with authorized/valid electronic signature
JEFFREY M. NAKHJAVAN, DO, P.C. 401(K) PLAN 2020 204693555 2021-10-02 JEFFREY M. NAKHJAVAN, DO, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6313921916
Plan sponsor’s mailing address 4 FOX HOLLOW COURT, DIX HILLS, NY, 11746
Plan sponsor’s address 760 SUNRISE HIGHWAY, WEST BABYLON, NY, 11704

Number of participants as of the end of the plan year
Active participants 12
Other retired or separated participants entitled to future benefits 2
Number of participants with account balances as of the end of the plan year 11

Signature of
Role Plan administrator
Date 2021-10-02
Name of individual signing JEFFREY NAKHJAVAN
Valid signature Filed with authorized/valid electronic signature
JEFFREY M. NAKHJAVAN, DO, P.C. 401(K) PLAN 2019 204693555 2020-09-06 JEFFREY M. NAKHJAVAN, DO, P.C. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6313921916
Plan sponsor’s mailing address 4 FOX HOLLOW COURT, DIX HILLS, NY, 11746
Plan sponsor’s address 760 SUNRISE HIGHWAY, WEST BABYLON, NY, 11704

Number of participants as of the end of the plan year
Active participants 10
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 1
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 10
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2020-09-06
Name of individual signing JEFFREY NAKHJAVAN
Valid signature Filed with authorized/valid electronic signature
JEFFREY M. NAKHJAVAN, DO, P.C. 401(K) PLAN 2018 204693555 2019-10-02 JEFFREY M. NAKHJAVAN, DO, P.C. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6313921916
Plan sponsor’s mailing address 4 FOX HOLLOW COURT, DIX HILLS, NY, 11746
Plan sponsor’s address 760 SUNRISE HIGHWAY, WEST BABYLON, NY, 11704

Number of participants as of the end of the plan year
Active participants 15
Other retired or separated participants entitled to future benefits 2
Number of participants with account balances as of the end of the plan year 9

Signature of
Role Plan administrator
Date 2019-10-02
Name of individual signing JEFFREY NAKHJAVAN
Valid signature Filed with authorized/valid electronic signature
JEFFREY M. NAKHJAVAN, DO, P.C. 401(K) PLAN 2017 204693555 2018-09-23 JEFFREY M. NAKHJAVAN, DO, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6313921916
Plan sponsor’s mailing address 4 FOX HOLLOW COURT, DIX HILLS, NY, 11746
Plan sponsor’s address 760 SUNRISE HIGHWAY, WEST BABYLON, NY, 11704

Number of participants as of the end of the plan year
Active participants 16
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 1
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 9

Signature of
Role Plan administrator
Date 2018-09-23
Name of individual signing JEFFREY NAKHJAVAN
Valid signature Filed with authorized/valid electronic signature
JEFFREY M. NAKHJAVAN, DO, P.C. 401(K) PLAN 2012 204693555 2013-09-11 JEFFREY M. NAKHJAVAN, DO, P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6313921916
Plan sponsor’s mailing address 760 SUNRISE HIGHWAY, WEST BABYLON, NY, 11704
Plan sponsor’s address 760 SUNRISE HIGHWAY, WEST BABYLON, NY, 11704

Plan administrator’s name and address
Administrator’s EIN 204693555
Plan administrator’s name JEFFREY M. NAKHJAVAN, DO, P.C.
Plan administrator’s address 760 SUNRISE HIGHWAY, WEST BABYLON, NY, 11704
Administrator’s telephone number 6313921916

Number of participants as of the end of the plan year
Active participants 6
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 3
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2013-09-11
Name of individual signing JEFFREY NAKHJAVAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-09-11
Name of individual signing JEFFREY NAKHJAVAN
Valid signature Filed with authorized/valid electronic signature
JEFFREY M. NAKHJAVAN, DO, P.C. 401(K) PLAN 2011 204693555 2012-10-10 JEFFREY M. NAKHJAVAN, DO, P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6313921916
Plan sponsor’s mailing address 760 SUNRISE HIGHWAY, WEST BABYLON, NY, 11704
Plan sponsor’s address 760 SUNRISE HIGHWAY, WEST BABYLON, NY, 11704

Plan administrator’s name and address
Administrator’s EIN 204693555
Plan administrator’s name JEFFREY M. NAKHJAVAN, DO, P.C.
Plan administrator’s address 760 SUNRISE HIGHWAY, WEST BABYLON, NY, 11704
Administrator’s telephone number 6313921916

Number of participants as of the end of the plan year
Active participants 3
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 3
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-10-10
Name of individual signing JEFFREY NAKHJAVAN
Valid signature Filed with authorized/valid electronic signature
JEFFREY M. NAKHJAVAN, DO, P.C. 401(K) PLAN 2010 204693555 2011-10-05 JEFFREY M. NAKHJAVAN, DO, P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6313921916
Plan sponsor’s mailing address 1400 DEER PARK AV, NORTH BABYLON, NY, 31508
Plan sponsor’s address 1400 DEER PARK AV, NORTH BABYLON, NY, 31508

Plan administrator’s name and address
Administrator’s EIN 204693555
Plan administrator’s name JEFFREY M. NAKHJAVAN, DO, P.C.
Plan administrator’s address 1400 DEER PARK AV, NORTH BABYLON, NY, 31508
Administrator’s telephone number 6313921916

Number of participants as of the end of the plan year
Active participants 5
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 3
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-10-05
Name of individual signing JEFFREY NAKHJAVAN
Valid signature Filed with authorized/valid electronic signature

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent JEFFREY M. NAKHJAVAN, DO, 4 FOX HOLLOW COURT, DIX HILLS, NY, United States, 11746

History

Start date End date Type Value
2021-10-02 2022-10-14 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2006-04-12 2021-10-02 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
060412000782 2006-04-12 CERTIFICATE OF INCORPORATION 2006-04-12

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Related by address

No related companies by address

Date of last update: 31 Dec 2024

Sources: New York Secretary of State

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