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  5. PARK LENOX EMERGENCY MEDICINE, P.C.

PARK LENOX EMERGENCY MEDICINE, P.C.

Company Details

Name: PARK LENOX EMERGENCY MEDICINE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 09 Apr 2008 (17 years ago)
Entity Number: 3655934
ZIP code: 11042
County: New York
Place of Formation: New York
Address: 2000 Marcus Avenue, New Hyde Park, NY, United States, 11042
Principal Address: C/O NORTHWELL HEALTH, 972 BRUSH HOLLOW ROAD, 5TH FL, WESTBURY, NY, United States, 11590

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
PARK LENOX EMERGENCY MEDICINE, P.C. CASH BALANCE PENSION PLAN AND TRUST 2014 262661082 2015-09-23 PARK LENOX EMERGENCY MEDICINE, P.C. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2124343040
Plan sponsor’s address 100 EAST 77TH STREET, NEW YORK, NY, 10075

Signature of
Role Plan administrator
Date 2015-09-23
Name of individual signing ANDREW SAMA, M.D.
PARK LENOX EMERGENCY MEDICINE, P.C. CASH BALANCE PENSION PLAN AND TRUST 2013 262661082 2014-09-30 PARK LENOX EMERGENCY MEDICINE, P.C. 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2124343040
Plan sponsor’s address 100 EAST 77TH STREET, NEW YORK, NY, 10075

Signature of
Role Plan administrator
Date 2014-09-30
Name of individual signing ANDREW SAMA, M.D.
PARK LENOX EMERGENCY MEDICINE, P.C. CASH BALANCE PENSION PLAN AND TRUST 2012 262661082 2013-10-10 PARK LENOX EMERGENCY MEDICINE, P.C. 10
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2124343040
Plan sponsor’s address 100 EAST 77TH STREET, NEW YORK, NY, 10075

Signature of
Role Plan administrator
Date 2013-10-10
Name of individual signing ANDREW SAMA, M.D.
PARK LENOX EMERGENCY MEDICINE, P.C. CASH BALANCE PENSION PLAN AND TRUST 2012 262661082 2014-09-30 PARK LENOX EMERGENCY MEDICINE, P.C. 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2124343040
Plan sponsor’s address 100 EAST 77TH STREET, NEW YORK, NY, 10075

Signature of
Role Plan administrator
Date 2014-09-30
Name of individual signing ANDREW SAMA, M.D.
PARK LENOX EMERGENCY MEDICINE, P.C. INCENTIVE SAVINGS PLAN AND TRUST 2012 262661082 2013-02-05 PARK LENOX EMERGENCY MEDICINE, P.C. 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2124343040
Plan sponsor’s address 100 EAST 77TH STREET, NEW YORK, NY, 10075

Signature of
Role Plan administrator
Date 2013-02-05
Name of individual signing ANDREW SAMA, M.D.
PARK LENOX EMERGENCY MEDICINE, P.C. CASH BALANCE PENSION PLAN AND TRUST 2011 262661082 2012-10-10 PARK LENOX EMERGENCY MEDICINE, P.C. 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2124343040
Plan sponsor’s address 100 EAST 77TH STREET, NEW YORK, NY, 10075

Plan administrator’s name and address
Administrator’s EIN 262661082
Plan administrator’s name PARK LENOX EMERGENCY MEDICINE, P.C.
Plan administrator’s address 100 EAST 77TH STREET, NEW YORK, NY, 10075
Administrator’s telephone number 2124343040

Signature of
Role Plan administrator
Date 2012-10-10
Name of individual signing ANDREW SAMA, M.D.
PARK LENOX EMERGENCY MEDICINE, P.C. INCENTIVE SAVINGS PLAN AND TRUST 2011 262661082 2013-01-04 PARK LENOX EMERGENCY MEDICINE, P.C. 45
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2124343040
Plan sponsor’s address 100 EAST 77TH STREET, NEW YORK, NY, 10075

Plan administrator’s name and address
Administrator’s EIN 262661082
Plan administrator’s name PARK LENOX EMERGENCY MEDICINE, P.C.
Plan administrator’s address 100 EAST 77TH STREET, NEW YORK, NY, 10075
Administrator’s telephone number 2124343040

Signature of
Role Plan administrator
Date 2013-01-04
Name of individual signing ANDREW SAMA, M.D.
PARK LENOX EMERGENCY MEDICINE, P.C. INCENTIVE SAVINGS PLAN AND TRUST 2011 262661082 2013-01-09 PARK LENOX EMERGENCY MEDICINE, P.C. 45
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2124343040
Plan sponsor’s address 100 EAST 77TH STREET, NEW YORK, NY, 10075

Plan administrator’s name and address
Administrator’s EIN 262661082
Plan administrator’s name PARK LENOX EMERGENCY MEDICINE, P.C.
Plan administrator’s address 100 EAST 77TH STREET, NEW YORK, NY, 10075
Administrator’s telephone number 2124343040

Signature of
Role Plan administrator
Date 2013-01-09
Name of individual signing ANDREW SAMA, M.D.
PARK LENOX EMERGENCY MEDICINE, P.C. INCENTIVE SAVINGS PLAN AND TRUST 2011 262661082 2013-01-09 PARK LENOX EMERGENCY MEDICINE, P.C. 45
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2124343040
Plan sponsor’s address 100 EAST 77TH STREET, NEW YORK, NY, 10075

Plan administrator’s name and address
Administrator’s EIN 262661082
Plan administrator’s name PARK LENOX EMERGENCY MEDICINE, P.C.
Plan administrator’s address 100 EAST 77TH STREET, NEW YORK, NY, 10075
Administrator’s telephone number 2124343040

Signature of
Role Plan administrator
Date 2013-01-09
Name of individual signing ANDREW SAMA, M.D.
PARK LENOX EMERGENCY MEDICINE, P.C. INCENTIVE SAVINGS PLAN AND TRUST 2011 262661082 2012-09-28 PARK LENOX EMERGENCY MEDICINE, P.C. 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2124343040
Plan sponsor’s address 100 EAST 77TH STREET, NEW YORK, NY, 10075

Plan administrator’s name and address
Administrator’s EIN 262661082
Plan administrator’s name PARK LENOX EMERGENCY MEDICINE, P.C.
Plan administrator’s address 100 EAST 77TH STREET, NEW YORK, NY, 10075
Administrator’s telephone number 2124343040

Signature of
Role Plan administrator
Date 2012-09-28
Name of individual signing ANDREW SAMA, M.D.

DOS Process Agent

Name Role Address
GENERAL COUNSEL - OFFICE OF LEGAL AFFAIRS DOS Process Agent 2000 Marcus Avenue, New Hyde Park, NY, United States, 11042

Chief Executive Officer

Name Role Address
MICHAEL J. DOWLING Chief Executive Officer 2000 MARCUS AVENUE, NEW HYDE PARK, NY, United States, 11042

History

Start date End date Type Value
2014-04-29 2017-11-17 Address C/O NORTH SHORE-LIJ HEALTH SYS, 972 BRUSH HOLLOW ROAD, 5TH FL, WESTBURY, NY, 11590, USA (Type of address: Principal Executive Office)
2014-04-29 2018-03-01 Address ATTN: LEGAL AFFAIRS DEPT, 145 COMMUNITY DRIVE, GREAT NECK, NY, 11021, USA (Type of address: Service of Process)
2011-04-05 2014-04-29 Address 100 EAST 77TH ST, NEW YORK, NY, 10075, USA (Type of address: Principal Executive Office)
2011-04-05 2014-04-29 Address 100 EAST 77TH ST, NEW YORK, NY, 10075, USA (Type of address: Chief Executive Officer)
2011-03-18 2011-04-05 Address 100 EAST 77TH ST, NEW YORK, NY, 10075, USA (Type of address: Principal Executive Office)
2011-03-18 2011-04-05 Address 100 E 77TH ST, NEW YORK, NY, 10075, USA (Type of address: Chief Executive Officer)
2010-04-20 2011-03-18 Address 100 E 77TH ST, NEW YORK, NY, 10075, USA (Type of address: Chief Executive Officer)
2010-04-20 2011-03-18 Address 100 E 77TH ST, NEW YORK, NY, 10075, USA (Type of address: Principal Executive Office)
2008-04-09 2014-04-29 Address ATTN: PRESIDENT C/O LENOX HILL, HOSPITAL, 100 EAST 77TH STREET, NEW YORK, NY, 10075, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
210825001059 2021-08-25 BIENNIAL STATEMENT 2021-08-25
180301000700 2018-03-01 CERTIFICATE OF CHANGE 2018-03-01
171117006130 2017-11-17 BIENNIAL STATEMENT 2016-04-01
140429006243 2014-04-29 BIENNIAL STATEMENT 2014-04-01
120806002517 2012-08-06 BIENNIAL STATEMENT 2012-04-01
111011000090 2011-10-11 CERTIFICATE OF AMENDMENT 2011-10-11
110405003143 2011-04-05 AMENDMENT TO BIENNIAL STATEMENT 2010-04-01
110318002035 2011-03-18 AMENDMENT TO BIENNIAL STATEMENT 2010-04-01
101229000432 2010-12-29 CERTIFICATE OF MERGER 2010-12-31
100420002621 2010-04-20 BIENNIAL STATEMENT 2010-04-01

Related by officers

GENERAL COUNSEL - OFFICE OF LEGAL AFFAIRS

ADVANCED HEART PHYSICIANS & SURGEONS NETWORK, P.C. BRIGHTWATERS GYNECOLOGY, P.C. CARNEGIE CARDIOVASCULAR, P.C. COMMUNITY DRIVE SURGERY, P.C. LAKEVILLE SURGERY, P.C. LENOX HILL CARDIOLOGY ASSOCIATES, P.C. LYNBROOK SC, LLC MANHATTAN MINIMALLY INVASIVE AND BARIATRIC SURGERY, P.C. MATHER PRIMARY CARE PLLC MEDICAL CARE OF QUEENS, P.C.

MICHAEL J. DOWLING

NORTH SHORE-LIJ MEDICAL, P.C. CARNEGIE CARDIOVASCULAR, P.C. COMMUNITY DRIVE SURGERY, P.C. LENOX HILL INTERVENTIONAL CARDIAC & VASCULAR SERVICES, P.C. BLACK HALL ORAL MAXILLOFACIAL SURGERY, P.C. MEDICAL SERVICES OF RIVERHEAD, P.C. LAKEVILLE SURGERY, P.C. TRUE NORTH WORKFORCE SAFETY CONSULTING, INC. TRUE NORTH MEDICAL OF SOUTH NASSAU, P.C. TRUE NORTH MEDICAL OF LENOX HILL, P.C.

Related by address

2000 Marcus Avenue, New Hyde Park, NY, United States, 11042

BLACK HALL ORAL MAXILLOFACIAL SURGERY, P.C. BRIGHTWATERS GYNECOLOGY, P.C. LAKEVILLE SURGERY, P.C. MARCUS AVENUE MEDICAL, P.C. MARCUS AVENUE OB/GYN, P.C. MEDICAL CARE OF QUEENS, P.C. MEDICAL SERVICES OF BELLMORE, P.C. MEDICAL SERVICES OF LENOX HILL, P.C. MEDICAL SERVICES OF MANHASSET, P.C. MEDICAL SERVICES OF NASSAU, P.C.

Date of last update: 17 Jan 2025

Sources: New York Secretary of State

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