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David S. Pomerantz, MD, Inc.

Company Details

Name: David S. Pomerantz, MD, Inc.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Activ
Date of Organization in Rhode Island: 24 Jan 2001 (24 years ago)
Identification Number: 000116494
ZIP code: 02860
County: Providence County
Principal Address: 333 SCHOOL STREET SUITE 112A, PAWTUCKET, RI, 02860, USA
Purpose: DERMATOLOGY
Fictitious names: School Street Dermatology (trading name, 2010-07-19 - )

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1497780993 2006-07-12 2022-05-23 333 SCHOOL ST STE 112A, PAWTUCKET, RI, 028605336, US 333 SCHOOL STREET, SUITE 216, PAWTUCKET, RI, 02860, US

Contacts

Phone +1 401-728-6990
Fax 4017290930

Authorized person

Name DAVID S POMERANTZ
Role PRESIDENT
Phone 4017286990

Taxonomy

Taxonomy Code 207N00000X - Dermatology Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DAVID S. POMERANTZ, MD, INC. 401(K) PLAN 2023 050515697 2024-06-06 DAVID S. POMERANTZ, MD, INC. 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4017286990
Plan sponsor’s address 333 SCHOOL STREET, SUITE 112A, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2024-06-06
Name of individual signing DAVID POMERANTZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-06-06
Name of individual signing DAVID POMERANTZ
Valid signature Filed with authorized/valid electronic signature
DAVID S. POMERANTZ, MD, INC. 401(K) PLAN 2022 050515697 2023-05-25 DAVID S. POMERANTZ, MD, INC. 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4017286990
Plan sponsor’s address 333 SCHOOL STREET, SUITE 112A, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2023-05-25
Name of individual signing DAVID S POMERANTZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-05-25
Name of individual signing DAVID S POMERANTZ
Valid signature Filed with authorized/valid electronic signature
DAVID S. POMERANTZ, MD, INC. 401(K) PLAN 2021 050515697 2022-05-06 DAVID S. POMERANTZ, MD, INC. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4017286990
Plan sponsor’s address 333 SCHOOL STREET, SUITE 112A, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2022-05-06
Name of individual signing DAVID POMERANTZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-05-06
Name of individual signing DAVID POMERANTZ
Valid signature Filed with authorized/valid electronic signature
DAVID S. POMERANTZ, MD, INC. 401(K) PLAN 2020 050515697 2021-04-21 DAVID S. POMERANTZ, MD, INC. 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4017286990
Plan sponsor’s address 333 SCHOOL STREET, SUITE 112A, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2021-04-21
Name of individual signing DAVID POMERANTZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-21
Name of individual signing DAVID POMERANTZ
Valid signature Filed with authorized/valid electronic signature
DAVID S. POMERANTZ, MD, INC. 401(K) PLAN 2019 050515697 2020-05-26 DAVID S. POMERANTZ, MD, INC. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4017286990
Plan sponsor’s address 333 SCHOOL STREET, SUITE 112A, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2020-05-26
Name of individual signing DAVID POMERANTZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-05-26
Name of individual signing DAVID POMERANTZ
Valid signature Filed with authorized/valid electronic signature
DAVID S. POMERANTZ, MD, INC. 401(K) PLAN 2018 050515697 2019-09-20 DAVID S. POMERANTZ, MD, INC. 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4017286990
Plan sponsor’s address 333 SCHOOL STREET, SUITE 112A, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2019-09-20
Name of individual signing DAVID POMERANTZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-20
Name of individual signing DAVID POMERANTZ
Valid signature Filed with authorized/valid electronic signature
DAVID S. POMERANTZ, MD, INC. 401(K) PLAN 2017 050515697 2018-09-24 DAVID S. POMERANTZ, MD, INC. 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4017286990
Plan sponsor’s address 333 SCHOOL STREET, SUITE 112A, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2018-09-24
Name of individual signing DAVID POMERANTZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-09-24
Name of individual signing DAVID POMERANTZ
Valid signature Filed with authorized/valid electronic signature
DAVID S. POMERANTZ, MD, INC. 401(K) PLAN 2016 050515697 2017-09-15 DAVID S. POMERANTZ, MD, INC. 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4017286990
Plan sponsor’s address 333 SCHOOL STREET, SUITE 112A, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2017-09-15
Name of individual signing TIANNA KELLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-09-15
Name of individual signing TIANNA KELLER
Valid signature Filed with authorized/valid electronic signature
DAVID S. POMERANTZ, MD, INC. 401(K) PLAN 2015 050515697 2016-09-28 DAVID S. POMERANTZ, MD, INC. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4017286990
Plan sponsor’s address 333 SCHOOL STREET, SUITE 112A, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2016-09-28
Name of individual signing TIANNA KELLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-09-28
Name of individual signing TIANNA KELLER
Valid signature Filed with authorized/valid electronic signature
DAVID S. POMERANTZ, MD, INC. 401(K) PLAN 2014 050515697 2015-09-11 DAVID S. POMERANTZ, MD, INC. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4017286990
Plan sponsor’s address 333 SCHOOL STREET, SUITE 112A, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2015-09-11
Name of individual signing TIANNA KELLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-09-11
Name of individual signing TIANNA KELLER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/09/24/20140924091437P040005927359001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4017286990
Plan sponsor’s address 333 SCHOOL STREET, SUITE 112A, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2014-09-24
Name of individual signing TIANNA KELLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-09-24
Name of individual signing TIANNA KELLER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/23/20130723100118P040115569877001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4017286990
Plan sponsor’s address 333 SCHOOL STREET, SUITE 216, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2013-07-23
Name of individual signing TIANNA KELLER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-23
Name of individual signing TIANNA KELLER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/03/26/20120326103342P040260732832001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4017286990
Plan sponsor’s address 333 SCHOOL STREET, PAWTUCKET, RI, 02860

Plan administrator’s name and address

Administrator’s EIN 050515697
Plan administrator’s name DAVID S. POMERANTZ, MD, INC.
Plan administrator’s address 333 SCHOOL STREET, PAWTUCKET, RI, 02860
Administrator’s telephone number 4017286990

Signature of

Role Plan administrator
Date 2012-03-26
Name of individual signing DONNA BORGES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-03-26
Name of individual signing DONNA BORGES
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/02/22/20110222084904P030004463287001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4017286990
Plan sponsor’s address 333 SCHOOL STREET, PAWTUCKET, RI, 02860

Plan administrator’s name and address

Administrator’s EIN 050515697
Plan administrator’s name DAVID S. POMERANTZ, MD, INC.
Plan administrator’s address 333 SCHOOL STREET, PAWTUCKET, RI, 02860
Administrator’s telephone number 4017286990

Signature of

Role Plan administrator
Date 2011-02-22
Name of individual signing DONNA BORGES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-02-22
Name of individual signing DONNA BORGES
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/09/01/20100901073946P070002151846001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 4017286990
Plan sponsor’s address 333 SCHOOL STREET, PAWTUCKET, RI, 02860

Plan administrator’s name and address

Administrator’s EIN 050515697
Plan administrator’s name DAVID S. POMERANTZ, MD, INC.
Plan administrator’s address 333 SCHOOL STREET, PAWTUCKET, RI, 02860
Administrator’s telephone number 4017286990

Signature of

Role Plan administrator
Date 2010-09-01
Name of individual signing DONNA BORGES
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-09-01
Name of individual signing DONNA BORGES
Valid signature Filed with authorized/valid electronic signature

PRESIDENT

Name Role Address
DAVID S. POMERANTZ MD PRESIDENT 333 SCHOOL STREET SUITE 112A PAWTUCKET, RI 02860 USA

Agent

Name Role Address
ANDREW M. GILSTEIN, ESQ. Agent 300 METRO CENTER BOULEVARD SUITE 150A, WARWICK, RI, 02886, USA

Filings

Number Name File Date
202451183800 Annual Report 2024-04-15
202335116270 Annual Report 2023-05-01
202217014760 Annual Report 2022-04-29
202191300730 Annual Report 2021-02-10
202035509930 Annual Report 2020-02-27
201986123530 Annual Report 2019-02-06
201858903950 Annual Report 2018-02-20
201737205430 Annual Report 2017-03-01
201692897840 Annual Report 2016-02-22
201555373470 Annual Report 2015-02-19

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
6869607001 2020-04-07 0165 PPP 333 SCHOOL ST, PAWTUCKET, RI, 02860-5300
Loan Status Date 2021-05-12
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 286700
Loan Approval Amount (current) 286700
Undisbursed Amount 0
Franchise Name -
Lender Location ID 120245
Servicing Lender Name Bank Rhode Island
Servicing Lender Address One Turks Head Place, PROVIDENCE, RI, 02903-2219
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address PAWTUCKET, PROVIDENCE, RI, 02860-5300
Project Congressional District RI-01
Number of Employees 23
NAICS code 621111
Borrower Race White
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 120245
Originating Lender Name Bank Rhode Island
Originating Lender Address PROVIDENCE, RI
Gender Male Owned
Veteran Unanswered
Forgiveness Amount 289551.07
Forgiveness Paid Date 2021-04-14
9523728408 2021-02-17 0165 PPS 333 School St Ste 112A, Pawtucket, RI, 02860-5336
Loan Status Date 2021-11-16
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 205955.9
Loan Approval Amount (current) 205955.9
Undisbursed Amount 0
Franchise Name -
Lender Location ID 120245
Servicing Lender Name Bank Rhode Island
Servicing Lender Address One Turks Head Place, PROVIDENCE, RI, 02903-2219
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Pawtucket, PROVIDENCE, RI, 02860-5336
Project Congressional District RI-01
Number of Employees 21
NAICS code 621111
Borrower Race White
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 120245
Originating Lender Name Bank Rhode Island
Originating Lender Address PROVIDENCE, RI
Gender Male Owned
Veteran Unanswered
Forgiveness Amount 207248.85
Forgiveness Paid Date 2021-10-06

Date of last update: 10 Apr 2025

Sources: Rhode Island Department of State