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PEDIATRIC AND ADOLESCENT UROLOGY INSTITUTE, LLC

Company Details

Name: PEDIATRIC AND ADOLESCENT UROLOGY INSTITUTE, LLC
Jurisdiction: New York
Legal type: FOREIGN PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 30 May 2018 (7 years ago)
Entity Number: 5349679
ZIP code: 10005
County: Nassau
Place of Formation: Ohio
Address: 28 LIBERTY ST., NEW YORK, NY, United States, 10005

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PEDIATRIC AND ADOLESCENT UROLOGY INSTITUTE, LLC CASH BALANCE PLAN 2018 272435963 2019-11-29 PEDIATRIC AND ADOLESCENT UROLOGY INSTITUTE, LLC 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2162922111
Plan sponsor’s address 10 CARTHAGE LANE, SCARSDALE, NY, 10583

Signature of

Role Plan administrator
Date 2019-11-29
Name of individual signing JEFFREY PALMER
PEDIATRIC AND ADOLESCENT UROLOGY INSTITUTE, LLC CASH BALANCE PLAN 2018 272435963 2019-05-27 PEDIATRIC AND ADOLESCENT UROLOGY INSTITUTE, LLC 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2162922111
Plan sponsor’s address P O BOX 633, MAMARONECK, NY, 10543

Signature of

Role Plan administrator
Date 2019-05-27
Name of individual signing JEFFREY PALMER
PEDIATRIC AND ADOLESCENT UROLOGY INSTITUTE, LLC 401(K) PLAN 2018 272435963 2019-12-24 PEDIATRIC AND ADOLESCENT UROLOGY INSTITUTE, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2162922111
Plan sponsor’s address 10 CARTHAGE LANE, SCARSDALE, NY, 10583

Signature of

Role Plan administrator
Date 2019-12-24
Name of individual signing JEFFREY PALMER
PEDIATRIC AND ADOLESCENT UROLOGY INSTITUTE, LLC 401(K) PLAN 2018 272435963 2019-10-04 PEDIATRIC AND ADOLESCENT UROLOGY INSTITUTE, LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2162922111
Plan sponsor’s address 10 CARTHAGE LANE, SCARSDALE, NY, 10583

Signature of

Role Plan administrator
Date 2019-10-04
Name of individual signing JEFFREY PALMER
PEDIATRIC AND ADOLESCENT UROLOGY INSTITUTE, LLC CASH BALANCE PLAN 2017 272435963 2018-10-01 PEDIATRIC AND ADOLESCENT UROLOGY INSTITUTE, LLC 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2162922111
Plan sponsor’s address P O BOX 633, MAMARONECK, NY, 10543

Signature of

Role Plan administrator
Date 2018-10-01
Name of individual signing JEFFREY PALMER
PEDIATRIC AND ADOLESCENT UROLOGY INSTITUTE, LLC 401(K) PLAN 2017 272435963 2018-10-05 PEDIATRIC AND ADOLESCENT UROLOGY INSTITUTE, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 2162922111
Plan sponsor’s address P O BOX 633, MAMARONECK, NY, 10543

Signature of

Role Plan administrator
Date 2018-10-05
Name of individual signing JEFFREY PALMER

DOS Process Agent

Name Role Address
C T CORPORATION SYSTEM DOS Process Agent 28 LIBERTY ST., NEW YORK, NY, United States, 10005

History

Start date End date Type Value
2018-05-30 2019-01-28 Address 111 EIGHTH AVENUE, 13TH FLOOR, NEW YORK, NY, 10011, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
SR-83141 2019-01-28 CERTIFICATE OF CHANGE 2019-01-28
180530000143 2018-05-30 APPLICATION OF AUTHORITY 2018-05-30

Date of last update: 30 Jan 2025

Sources: New York Secretary of State