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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 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 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, 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

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 16 Jan 2025

Sources: New York Secretary of State

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