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  5. BETHEL MEDICAL GROUP, P.C.

BETHEL MEDICAL GROUP, P.C.

Company Details

Entity Name: BETHEL MEDICAL GROUP, P.C.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Forfeited
Date Formed: 15 Dec 1976
Business ALEI: 0015192
Business address: 155 GREENWOOD AVE, BETHEL, CT, 06801
ZIP code: 06801
County: Fairfield
Place of Formation: CONNECTICUT
Total authorized shares: 5000
E-Mail: evolpintesta@snet.net

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BETHEL MEDICAL GROUP, P.C. 401(K) PROFIT SHARING PLAN 2017 060951458 2018-05-11 BETHEL MEDICAL GROUP, P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-04-01
Business code 621111
Sponsor’s telephone number 2037441734
Plan sponsor’s address 155 GREENWOOD AVENUE, BETHEL, CT, 06801

Signature of
Role Plan administrator
Date 2018-05-10
Name of individual signing DAVID SHAPIRO
Valid signature Filed with authorized/valid electronic signature
BETHEL MEDICAL GROUP, P.C. 401(K) PROFIT SHARING PLAN 2017 060951458 2018-04-03 BETHEL MEDICAL GROUP, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-04-01
Business code 621111
Sponsor’s telephone number 2037441734
Plan sponsor’s address 155 GREENWOOD AVENUE, BETHEL, CT, 06801

Signature of
Role Plan administrator
Date 2018-03-29
Name of individual signing DAVID SHAPIRO
Valid signature Filed with authorized/valid electronic signature
BETHEL MEDICAL GROUP, P.C. 401(K) PROFIT SHARING PLAN 2016 060951458 2017-04-05 BETHEL MEDICAL GROUP, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-04-01
Business code 621111
Sponsor’s telephone number 2037441734
Plan sponsor’s address 155 GREENWOOD AVENUE, BETHEL, CT, 06801

Signature of
Role Plan administrator
Date 2017-04-05
Name of individual signing DAVID SHAPIRO
Valid signature Filed with authorized/valid electronic signature
BETHEL MEDICAL GROUP, P.C. 401(K) PROFIT SHARING PLAN 2015 060951458 2016-05-02 BETHEL MEDICAL GROUP, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-04-01
Business code 621111
Sponsor’s telephone number 2037441734
Plan sponsor’s address 155 GREENWOOD AVENUE, BETHEL, CT, 06801

Signature of
Role Plan administrator
Date 2016-05-02
Name of individual signing DAVID SHAPIRO
Valid signature Filed with authorized/valid electronic signature
BETHEL MEDICAL GROUP, P.C. 401(K) PROFIT SHARING PLAN 2014 060951458 2015-03-31 BETHEL MEDICAL GROUP, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-04-01
Business code 621111
Sponsor’s telephone number 2037441734
Plan sponsor’s address 155 GREENWOOD AVENUE, BETHEL, CT, 06801

Signature of
Role Plan administrator
Date 2015-03-31
Name of individual signing DAVID SHAPIRO
Valid signature Filed with authorized/valid electronic signature
BETHEL MEDICAL GROUP, P.C. 401(K) PROFIT SHARING PLAN 2013 060951458 2014-05-20 BETHEL MEDICAL GROUP, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-04-01
Business code 621111
Sponsor’s telephone number 2037441734
Plan sponsor’s address 155 GREENWOOD AVENUE, BETHEL, CT, 06801

Signature of
Role Plan administrator
Date 2014-05-20
Name of individual signing DAVID SHAPIRO
Valid signature Filed with authorized/valid electronic signature
BETHEL MEDICAL GROUP, P.C. 401(K) PROFIT SHARING PLAN 2012 060951458 2013-05-15 BETHEL MEDICAL GROUP, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-04-01
Business code 621111
Sponsor’s telephone number 2037441734
Plan sponsor’s address 155 GREENWOOD AVENUE, BETHEL, CT, 06801

Signature of
Role Plan administrator
Date 2013-05-15
Name of individual signing DAVID SHAPIRO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-15
Name of individual signing DAVID SHAPIRO
Valid signature Filed with authorized/valid electronic signature
BETHEL MEDICAL GROUP, P.C. 401(K) PROFIT SHARING PLAN 2011 060951458 2012-06-28 BETHEL MEDICAL GROUP, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-04-01
Business code 621111
Sponsor’s telephone number 2037441734
Plan sponsor’s address 155 GREENWOOD AVENUE, BETHEL, CT, 06801

Plan administrator’s name and address
Administrator’s EIN 060951458
Plan administrator’s name BETHEL MEDICAL GROUP, P.C.
Plan administrator’s address 155 GREENWOOD AVENUE, BETHEL, CT, 06801
Administrator’s telephone number 2037441734

Signature of
Role Plan administrator
Date 2012-06-28
Name of individual signing DAVID SHAPIRO
Valid signature Filed with authorized/valid electronic signature
BETHEL MEDICAL GROUP, P.C. 401(K) PROFIT SHARING PLAN 2010 060951458 2011-06-15 BETHEL MEDICAL GROUP, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-04-01
Business code 621111
Sponsor’s telephone number 2037441734
Plan sponsor’s address 155 GREENWOOD AVENUE, BETHEL, CT, 06801

Plan administrator’s name and address
Administrator’s EIN 060951458
Plan administrator’s name BETHEL MEDICAL GROUP, P.C.
Plan administrator’s address 155 GREENWOOD AVENUE, BETHEL, CT, 06801
Administrator’s telephone number 2037441734

Signature of
Role Plan administrator
Date 2011-06-15
Name of individual signing DAVID SHAPIRO
Valid signature Filed with authorized/valid electronic signature
BETHEL MEDICAL GROUP, P.C. 401(K) PROFIT SHARING PLAN 2009 060951458 2010-06-10 BETHEL MEDICAL GROUP, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-04-01
Business code 621111
Sponsor’s telephone number 2037441734
Plan sponsor’s address 155 GREENWOOD AVENUE, BETHEL, CT, 06801

Plan administrator’s name and address
Administrator’s EIN 060951458
Plan administrator’s name BETHEL MEDICAL GROUP, P.C.
Plan administrator’s address 155 GREENWOOD AVENUE, BETHEL, CT, 06801
Administrator’s telephone number 2037441734

Signature of
Role Plan administrator
Date 2010-06-10
Name of individual signing DAVID SHAPIRO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address E-Mail Residence address
EDWARD J VOLPINTESTA Agent 155 GREENWOOD AVE, BETHEL, CT, 06801, United States evolpintesta@snet.net 4 BUCKBOARD RIDGE RD, BETHEL, CT, 06801, United States

Officer

Name Role Business address Residence address
EDWARD VOLPINTESTA Officer 155 GREENWOOD AVE, BETHEL, CT, 06801, United States 4 BUCKBOARD RIDGE, BETHEL, CT, 06801, United States
NAMI VOLPINTESTA Officer 155 GREENWOOD AVENUE, BETHEL, CT, 06801, United States 4 BUCKBOARD RIDGE, BETHEL, CT, 06801, United States

History

Type Old value New value Date of change
Name change EDWARD J. VOLPINTESTA, M.D., P.C. BETHEL MEDICAL GROUP, P.C. 1978-08-01

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0011910503 2023-08-02 No data Administrative Dissolution Certificate of Dissolution/Revocation No data
BF-0011785744 2023-05-02 No data Administrative Dissolution Notice of Intent to Dissolve/Revoke No data
0006091707 2018-02-22 No data Interim Notice Interim Notice No data
0005973945 2017-11-28 No data Annual Report Annual Report 2017
0005705250 2016-11-29 No data Annual Report Annual Report 2016
0005505743 2016-03-07 No data Annual Report Annual Report 2015
0005225266 2014-11-24 No data Annual Report Annual Report 2014
0004995431 2013-12-09 No data Annual Report Annual Report 2013
0004747924 2012-11-19 No data Annual Report Annual Report 2012
0004657175 2011-12-01 No data Annual Report Annual Report 2011

Related by officers

No related officers

Related by address

155 GREENWOOD AVE, BETHEL, CT, 06801

DAVID SHAPIRO, M.D., P.C.

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

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