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  5. GLENVILLE MEDICAL ASSOCIATES, P.C.

GLENVILLE MEDICAL ASSOCIATES, P.C.

Company Details

Entity Name: GLENVILLE MEDICAL ASSOCIATES, P.C.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 16 May 1977
Business ALEI: 0019586
Annual report due: 16 May 2025
NAICS code: 621111 - Offices of Physicians (except Mental Health Specialists)
Business address: 7 RIVERSVILLE ROAD, GREENWICH, CT, 06831, United States
Mailing address: 7 RIVERSVILLE ROAD, GREENWICH, CT, United States, 06831
ZIP code: 06831
County: Fairfield
Place of Formation: CONNECTICUT
Total authorized shares: 5000
E-Mail: virginiak@glenvillemedicalconciergecare.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GLENVILLE MEDICAL ASSOCIATES, P.C. CASH BALANCE PENSION PLAN 2023 060962211 2024-06-03 GLENVILLE MEDICAL ASSOCIATES, P.C. 13
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2035311808
Plan sponsor’s address 7 RIVERSVILLE ROAD, GREENWICH, CT, 06831

Signature of
Role Plan administrator
Date 2024-05-31
Name of individual signing JEFFREY PUGLISI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-05-31
Name of individual signing JEFFREY PUGLISI
Valid signature Filed with authorized/valid electronic signature
GLENVILLE MEDICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2023 060962211 2024-07-10 GLENVILLE MEDICAL ASSOCIATES, P.C. 20
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1978-06-26
Business code 621111
Sponsor’s telephone number 2035311808
Plan sponsor’s address 7 RIVERSVILLE ROAD, GREENWICH, CT, 06831

Signature of
Role Plan administrator
Date 2024-07-10
Name of individual signing JEFFREY PUGLISI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-07-10
Name of individual signing JEFFREY PUGLISI
Valid signature Filed with authorized/valid electronic signature
GLENVILLE MEDICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2022 060962211 2023-09-21 GLENVILLE MEDICAL ASSOCIATES, P.C. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1978-06-26
Business code 621111
Sponsor’s telephone number 2035311808
Plan sponsor’s address 7 RIVERSVILLE ROAD, GREENWICH, CT, 06831

Signature of
Role Plan administrator
Date 2023-09-21
Name of individual signing JEFFREY PUGLISI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-09-21
Name of individual signing JEFFREY PUGLISI
Valid signature Filed with authorized/valid electronic signature
GLENVILLE MEDICAL ASSOCIATES, P.C. CASH BALANCE PENSION PLAN 2022 060962211 2023-10-05 GLENVILLE MEDICAL ASSOCIATES, P.C. 13
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2035311808
Plan sponsor’s address 7 RIVERSVILLE ROAD, GREENWICH, CT, 06831

Signature of
Role Plan administrator
Date 2023-10-05
Name of individual signing JEFFREY PUGLISI
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-10-05
Name of individual signing JEFFREY PUGLISI
Valid signature Filed with authorized/valid electronic signature
GLENVILLE MEDICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2021 060962211 2022-09-20 GLENVILLE MEDICAL ASSOCIATES, P.C. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1978-06-26
Business code 621111
Sponsor’s telephone number 2035311808
Plan sponsor’s address 7 RIVERSVILLE ROAD, GREENWICH, CT, 06831

Signature of
Role Plan administrator
Date 2022-09-20
Name of individual signing STEVEN MICKLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-09-20
Name of individual signing STEVEN MICKLEY
Valid signature Filed with authorized/valid electronic signature
GLENVILLE MEDICAL ASSOCIATES, P.C. CASH BALANCE PENSION PLAN 2021 060962211 2022-10-07 GLENVILLE MEDICAL ASSOCIATES, P.C. 12
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2035311808
Plan sponsor’s address 7 RIVERSVILLE ROAD, GREENWICH, CT, 06831

Signature of
Role Plan administrator
Date 2022-10-07
Name of individual signing STEVEN MICKLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-10-07
Name of individual signing STEVEN MICKLEY
Valid signature Filed with authorized/valid electronic signature
GLENVILLE MEDICAL ASSOCIATES, P.C. CASH BALANCE PENSION PLAN 2020 060962211 2021-10-13 GLENVILLE MEDICAL ASSOCIATES, P.C. 11
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2035311808
Plan sponsor’s address 7 RIVERSVILLE ROAD, GREENWICH, CT, 06831

Signature of
Role Plan administrator
Date 2021-10-13
Name of individual signing STEVEN MICKLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-13
Name of individual signing STEVEN MICKLEY
Valid signature Filed with authorized/valid electronic signature
GLENVILLE MEDICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2020 060962211 2021-09-14 GLENVILLE MEDICAL ASSOCIATES, P.C. 19
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1978-06-26
Business code 621111
Sponsor’s telephone number 2035311808
Plan sponsor’s address 7 RIVERSVILLE ROAD, GREENWICH, CT, 06831

Signature of
Role Plan administrator
Date 2021-09-14
Name of individual signing STEVEN MICKLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-09-14
Name of individual signing STEVEN MICKLEY
Valid signature Filed with authorized/valid electronic signature
GLENVILLE MEDICAL ASSOCIATES, P.C. PROFIT SHARING PLAN 2019 060962211 2020-09-17 GLENVILLE MEDICAL ASSOCIATES, P.C. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1978-06-26
Business code 621111
Sponsor’s telephone number 2035311808
Plan sponsor’s address 7 RIVERSVILLE ROAD, GREENWICH, CT, 06831

Signature of
Role Plan administrator
Date 2020-09-17
Name of individual signing STEVEN MICKLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-09-17
Name of individual signing STEVEN MICKLEY
Valid signature Filed with authorized/valid electronic signature
GLENVILLE MEDICAL ASSOCIATES, P.C. CASH BALANCE PENSION PLAN 2019 060962211 2020-10-14 GLENVILLE MEDICAL ASSOCIATES, P.C. 11
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2035311808
Plan sponsor’s address 7 RIVERSVILLE ROAD, GREENWICH, CT, 06831

Signature of
Role Plan administrator
Date 2020-10-14
Name of individual signing STEVEN MICKLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-10-14
Name of individual signing STEVEN MICKLEY
Valid signature Filed with authorized/valid electronic signature

Officer

Name Role Business address Residence address
JEFFREY PUGLISI Officer 7 RIVERSVILLE RD., GREENWICH, CT, 06801, United States 39 WEED AVE., STAMFORD, CT, 06902, United States
JUDITH SHEA Officer 7 RIVERSVILLE RD., GREENWICH, CT, 06801, United States 18 BLIND BROOK LANE, GREENWICH, CT, 06831, United States

Agent

Name Role Business address Mailing address Phone E-Mail Residence address
Maryellen Astorino Agent 1 Bradley Road Bldg 600, Woodbridge, CT, 06525, United States 1 Bradley Road Bldg 600, Woodbridge, CT, 06525, United States +1 203-901-6060 maryellen@teplitzky.com 29 Virginia Rd, East Haven, CT, 06512-1232, United States

License

Credential Credential type Status Status reason Issue date Effective date Expiration date
CSP.0017884 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER ACTIVE CURRENT 1999-03-01 2023-03-01 2025-02-28
1.030567 Physician/Surgeon ACTIVE CURRENT 1990-02-09 2024-11-01 2025-10-31

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012712133 2024-11-21 No data Annual Report Annual Report No data
BF-0011704097 2023-02-17 2023-02-17 Reinstatement Certificate of Reinstatement No data
BF-0011698587 2023-02-14 No data Administrative Dissolution Certificate of Dissolution/Revocation No data
BF-0011057646 2022-11-10 No data Administrative Dissolution Notice of Intent to Dissolve/Revoke No data
BF-0008220863 2022-06-24 No data Annual Report Annual Report 2012
BF-0008220864 2022-06-24 No data Annual Report Annual Report 2013
BF-0010656115 2022-06-24 No data Annual Report Annual Report No data
BF-0010611013 2022-05-26 No data Administrative Dissolution Notice of Intent to Dissolve/Revoke No data
0004553082 2011-04-27 No data Annual Report Annual Report 2011
0004194283 2010-05-05 No data Annual Report Annual Report 2010

Related by officers

JEFFREY PUGLISI

GLENVILLE MEDICAL CONCIERGE CARE LLC

JUDITH SHEA

GLENVILLE MEDICAL CONCIERGE CARE LLC INTERFAITH COOPERATIVE MINISTRIES, INC. MARGRETA STAGE COMPANY

Maryellen Astorino

GCS LANDSCAPING LLC Kadense LLC

Related by address

No related companies by address

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

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