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  5. David S. Pomerantz, MD, Inc.

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

Agent

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

PRESIDENT

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

Related by officers

ANDREW M. GILSTEIN, ESQ.

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Related by address

No related companies by address

Date of last update: 08 Oct 2024

Sources: Rhode Island Department of State

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