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  5. FOREST HILLS DERMATOLOGY GROUP, PLLC

FOREST HILLS DERMATOLOGY GROUP, PLLC

Company Details

Name: FOREST HILLS DERMATOLOGY GROUP, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 09 Mar 2012 (13 years ago)
Entity Number: 4214673
ZIP code: 11375
County: Queens
Place of Formation: New York
Address: 107-40 Queens Boulevard, Suite 204, FOREST HILLS, NY, United States, 11375

Contact Details

Phone +1 718-459-0900

Phone +1 718-658-1700

Phone +1 718-651-8700

Phone +1 212-388-5338

Phone +1 212-222-0075

Phone +1 718-249-2201

Phone +1 718-380-2330

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FOREST HILLS DERMATOLOGY GROUP, PLLC 401(K) PLAN 2023 454098554 2024-04-01 FOREST HILLS DERMATOLOGY GROUP, PLLC 52
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7184590900
Plan sponsor’s address 80-02 KEW GARDENS ROAD, CONCOURSE LEVEL SUITE 107, KEW GARDENS, NY, 11415

Signature of
Role Plan administrator
Date 2024-04-01
Name of individual signing JEFFREY WEINBERG
FOREST HILLS DERMATOLOGY GROUP, PLLC DEFINED BENEFIT PLAN 2023 454098554 2024-09-23 FOREST HILLS DERMATOLOGY GROUP, PLLC 68
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7184590900
Plan sponsor’s address CONCOURSE LEVEL SUITE 101, 8002 KEW GARDENS RD, KEW GARDENS, NY, 11415

Signature of
Role Plan administrator
Date 2024-09-23
Name of individual signing JEFFREY WEINBERG
Valid signature Filed with authorized/valid electronic signature
FOREST HILLS DERMATOLOGY GROUP, PLLC DEFINED BENEFIT PLAN 2022 454098554 2023-10-07 FOREST HILLS DERMATOLOGY GROUP, PLLC 59
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7184590900
Plan sponsor’s address CONCOURSE LEVEL SUITE 107, 8002 KEW GARDENS RD, KEW GARDENS, NY, 114153600

Signature of
Role Plan administrator
Date 2023-10-07
Name of individual signing JEFFREY WEINBERG
FOREST HILLS DERMATOLOGY GROUP, PLLC 401(K) PLAN 2022 454098554 2023-04-17 FOREST HILLS DERMATOLOGY GROUP, PLLC 56
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7184590900
Plan sponsor’s address 80-02 KEW GARDENS ROAD, CONCOURSE LEVEL SUITE 107, KEW GARDENS, NY, 11415

Signature of
Role Plan administrator
Date 2023-04-17
Name of individual signing JEFFREY WEINBERG
FOREST HILLS DERMATOLOGY GROUP, PLLC 401(K) PLAN 2021 454098554 2022-10-11 FOREST HILLS DERMATOLOGY GROUP, PLLC 40
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7184590900
Plan sponsor’s address 80-02 KEW GARDENS ROAD, CONCOURSE LEVEL, SUITE 107, KEW GARDENS, NY, 11415

Signature of
Role Plan administrator
Date 2022-10-11
Name of individual signing JEFFREY WEINBERG
FOREST HILLS DERMATOLOGY GROUP DEFINED BENEFIT PLAN 2021 454098554 2022-10-03 FOREST HILLS DERMATOLOGY GROUP, PLLC 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7184590900
Plan sponsor’s address 80-02 KEW GARDENS ROAD, CONCOURSE LEVEL, SUITE 107, KEW GARDENS, NY, 11415

Signature of
Role Plan administrator
Date 2022-10-03
Name of individual signing JEFFREY WEINBERG
FOREST HILLS DERMATOLOGY GROUP, PLLC 401(K) PLAN 2020 454098554 2021-09-29 FOREST HILLS DERMATOLOGY GROUP, PLLC 30
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7184590900
Plan sponsor’s address 103-11 68TH DRIVE, FOREST HILLS, NY, 11375

Signature of
Role Plan administrator
Date 2021-09-29
Name of individual signing JEFFREY WEINBERG
FOREST HILLS DERMATOLOGY GROUP DEFINED BENEFIT PLAN 2020 454098554 2021-09-28 FOREST HILLS DERMATOLOGY GROUP, PLLC 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7184590900
Plan sponsor’s address 80-02 KEW GARDENS ROAD, CONCOURSE LEVEL, SUITE 107, KEW GARDENS, NY, 11415

Signature of
Role Plan administrator
Date 2021-09-28
Name of individual signing JEFFREY WEINBERG
FOREST HILLS DERMATOLOGY GROUP, PLLC 401(K) PLAN 2019 454098554 2020-10-15 FOREST HILLS DERMATOLOGY GROUP, PLLC 29
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7184590900
Plan sponsor’s address 103-11 68TH DRIVE, FOREST HILLS, NY, 11375

Plan administrator’s name and address
Administrator’s EIN 454098554
Plan administrator’s name FOREST HILLS DERMATOLOGY GROUP, PLLC
Plan administrator’s address 103-11 68TH DRIVE, FOREST HILLS, NY, 11375
Administrator’s telephone number 7184590900

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing JEFFREY WEINBERG
FOREST HILLS DERMATOLOGY GROUP DEFINED BENEFIT PLAN 2019 454098554 2020-10-15 FOREST HILLS DERMATOLOGY GROUP, PLLC 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-01-01
Business code 621111
Sponsor’s telephone number 7184590900
Plan sponsor’s address 103-11 68TH DRIVE, FOREST HILLS, NY, 11375

Plan administrator’s name and address
Administrator’s EIN 454098554
Plan administrator’s name FOREST HILLS DERMATOLOGY GROUP, PLLC
Plan administrator’s address 103-11 68TH DRIVE, FOREST HILLS, NY, 11375
Administrator’s telephone number 7184590900

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing JEFFREY WEINBERG

DOS Process Agent

Name Role Address
FOREST HILLS DERMATOLOGY GROUP, PLLC DOS Process Agent 107-40 Queens Boulevard, Suite 204, FOREST HILLS, NY, United States, 11375

History

Start date End date Type Value
2012-03-09 2024-03-01 Address 103-11 68TH DRIVE, FOREST HILLS, NY, 11375, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240301033107 2024-03-01 BIENNIAL STATEMENT 2024-03-01
230106003598 2023-01-06 BIENNIAL STATEMENT 2022-03-01
140513002046 2014-05-13 BIENNIAL STATEMENT 2014-03-01
120808000231 2012-08-08 CERTIFICATE OF PUBLICATION 2012-08-08
120309000806 2012-03-09 ARTICLES OF ORGANIZATION 2012-03-09

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3220537300 2020-04-29 0202 PPP 103-11 68TH DRIVE, FOREST HILLS, NY, 11375
Loan Status Date 2021-08-19
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 750000
Loan Approval Amount (current) 750000
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 FOREST HILLS, QUEENS, NY, 11375-0001
Project Congressional District NY-06
Number of Employees 75
NAICS code 621111
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 194093
Originating Lender Name JPMorgan Chase Bank, National Association
Originating Lender Address CHICAGO, IL
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 758738.26
Forgiveness Paid Date 2021-07-06
2598518407 2021-02-03 0202 PPS 10311 68th Dr, Forest Hills, NY, 11375-3159
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) 627500
Loan Approval Amount (current) 627500
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 Forest Hills, QUEENS, NY, 11375-3159
Project Congressional District NY-06
Number of Employees 70
NAICS code 621111
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 48270
Originating Lender Name JPMorgan Chase Bank, National Association
Originating Lender Address COLUMBUS, OH
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 631941.31
Forgiveness Paid Date 2021-10-25

Related by officers

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Date of last update: 26 Mar 2025

Sources: New York Secretary of State

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