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  5. CONNECTICUT PATHOLOGY GROUP, P.C.

CONNECTICUT PATHOLOGY GROUP, P.C.

Company Details

Entity Name: CONNECTICUT PATHOLOGY GROUP, P.C.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 12 Oct 1972
Business ALEI: 0031192
Annual report due: 12 Oct 2025
NAICS code: 621511 - Medical Laboratories
Business address: 28 CRESCENT STREET, MIDDLETOWN, CT, 06457, United States
Mailing address: MIDDLESEX MEM HOSP 28 CRESCENT ST, MIDDLETOWN, CT, United States, 06457
ZIP code: 06457
County: Middlesex
Place of Formation: CONNECTICUT
Total authorized shares: 5000
E-Mail: jonathan.levine@midhosp.org

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CONNECTICUT PATHOLOGY GROUP, P.C. 401(K) PROFIT SHARING PLAN 2023 060888504 2024-08-26 CONNECTICUT PATHOLOGY GROUP, P.C. 4
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 8603586176
Plan sponsor’s address 28 CRESCENT STREET, MIDDLETOWN, CT, 06457

Signature of
Role Plan administrator
Date 2024-08-25
Name of individual signing JONATHAN LEVINE
Valid signature Filed with authorized/valid electronic signature
CONNECTICUT PATHOLOGY GROUP, P.C. 401(K) PROFIT SHARING PLAN 2022 060888504 2023-07-27 CONNECTICUT PATHOLOGY GROUP, P.C. 4
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 8603586176
Plan sponsor’s address 28 CRESCENT STREET, MIDDLETOWN, CT, 06457

Signature of
Role Plan administrator
Date 2023-07-27
Name of individual signing JONATHAN LEVINE
Valid signature Filed with authorized/valid electronic signature
CONNECTICUT PATHOLOGY GROUP, P.C. SECTION 401(K) PROFIT SHARING PLAN 2021 060888504 2022-05-09 CONNECTICUT PATHOLOGY GROUP, P.C. 3
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 8603586176
Plan sponsor’s address 28 CRESCENT STREET, MIDDLETOWN, CT, 06457

Signature of
Role Plan administrator
Date 2022-05-09
Name of individual signing JONATHAN LEVINE
Valid signature Filed with authorized/valid electronic signature
CONNECTICUT PATHOLOGY GROUP, P.C. SECTION 401(K) PROFIT SHARING PLAN 2020 060888504 2021-04-29 CONNECTICUT PATHOLOGY GROUP, P.C. 4
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 8603586176
Plan sponsor’s address 28 CRESCENT STREET, MIDDLETOWN, CT, 06457

Signature of
Role Plan administrator
Date 2021-04-29
Name of individual signing JONATHAN LEVINE
Valid signature Filed with authorized/valid electronic signature
CONNECTICUT PATHOLOGY GROUP, P.C. SECTION 401(K) PROFIT SHARING PLAN 2019 060888504 2020-06-04 CONNECTICUT PATHOLOGY GROUP, P.C. 4
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 8603586176
Plan sponsor’s address 28 CRESCENT STREET, MIDDLETOWN, CT, 06457

Signature of
Role Plan administrator
Date 2020-06-04
Name of individual signing JONATHAN LEVINE
Valid signature Filed with authorized/valid electronic signature
CONNECTICUT PATHOLOGY GROUP, P.C. SECTION 401(K) PROFIT SHARING PLAN 2018 060888504 2019-03-05 CONNECTICUT PATHOLOGY GROUP, P.C. 4
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 8603586176
Plan sponsor’s address 28 CRESCENT STREET, MIDDLETOWN, CT, 06457

Signature of
Role Plan administrator
Date 2019-03-05
Name of individual signing JONATHAN LEVINE
Valid signature Filed with authorized/valid electronic signature
CONNECTICUT PATHOLOGY GROUP, P.C. SECTION 401(K) PROFIT SHARING PLAN 2017 060888504 2018-03-01 CONNECTICUT PATHOLOGY GROUP, P.C. 4
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 8603586176
Plan sponsor’s address 28 CRESCENT STREET, MIDDLETOWN, CT, 06457

Signature of
Role Plan administrator
Date 2018-03-01
Name of individual signing JONATHAN LEVINE
Valid signature Filed with authorized/valid electronic signature
CONNECTICUT PATHOLOGY GROUP, P.C. SECTION 401(K) PROFIT SHARING PLAN 2016 060888504 2017-04-12 CONNECTICUT PATHOLOGY GROUP, P.C. 4
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 8603586176
Plan sponsor’s address 28 CRESCENT STREET, MIDDLETOWN, CT, 06457

Signature of
Role Plan administrator
Date 2017-04-12
Name of individual signing JONATHAN LEVINE
Valid signature Filed with authorized/valid electronic signature
CONNECTICUT PATHOLOGY GROUP, P.C. SECTION 401(K) PROFIT SHARING PLAN 2015 060888504 2016-02-03 CONNECTICUT PATHOLOGY GROUP, P.C. 4
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 8603586176
Plan sponsor’s address 28 CRESCENT STREET, MIDDLETOWN, CT, 06457

Signature of
Role Plan administrator
Date 2016-02-03
Name of individual signing JONATHAN LEVINE
Valid signature Filed with authorized/valid electronic signature
CONNECTICUT PATHOLOGY GROUP, P.C. SECTION 401(K) PROFIT SHARING PLAN 2014 060888504 2015-03-17 CONNECTICUT PATHOLOGY GROUP, P.C. 4
File View Page
Three-digit plan number (PN) 004
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 8603586176
Plan sponsor’s address 28 CRESCENT STREET, MIDDLETOWN, CT, 06457

Signature of
Role Plan administrator
Date 2015-03-17
Name of individual signing JONATHAN LEVINE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Mailing address Phone E-Mail Residence address
JONATHAN D. LEVINE Agent 28 CRESCENT STREET, MIDDLETOWN, CT, 06457, United States 28 CRESCENT STREET, MIDDLETOWN, CT, 06457, United States +1 203-430-6430 jonathan.levine@midhosp.org 131 MILL STONE DRIVE, GUILFORD, CT, 06437, United States

Officer

Name Role Business address Residence address
JONATHAN DAVID LEVINE M.D. Officer 28 CRESCENT STREET, MIDDLETOWN, CT, 06457, United States 131 MILL STONE DRIVE, GUILFORD, CT, 06437, United States
Romulo Celli Officer 28 CRESCENT STREET, MIDDLETOWN, CT, 06457, United States 258 Village Pond Rd, Guilford, CT, 06437-2048, United States
BARTON CHARLES KENNEY Officer 28 CRESCENT ST, MIDDLETOWN, CT, 06457, United States 358 EAST POND MEADOW RD, WESTBROOK, CT, 06498, United States
JOSEPH PAUL SEMPLE M.D. Officer 28 CRESCENT STREET, MIDDLETOWN, CT, 06457, United States 3 North Main St, Chester, CT, 06412, United States

License

Credential Credential type Status Status reason Issue date Effective date Expiration date
CLAB.0001097 Clinical Laboratory ACTIVE CURRENT 2023-07-19 2023-07-19 2025-09-30

History

Type Old value New value Date of change
Name change MIDDLESEX PATHOLOGY GROUP, P.C. CONNECTICUT PATHOLOGY GROUP, P.C. 1989-05-19

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012339811 2024-09-25 No data Annual Report Annual Report No data
BF-0011087440 2023-09-15 No data Annual Report Annual Report No data
BF-0010366478 2022-10-06 No data Annual Report Annual Report 2022
BF-0009819427 2021-09-17 No data Annual Report Annual Report No data
0006984307 2020-09-22 No data Annual Report Annual Report 2020
0006644181 2019-09-13 No data Annual Report Annual Report 2019
0006289488 2018-12-10 No data Annual Report Annual Report 2017
0006289497 2018-12-10 No data Annual Report Annual Report 2018
0006289482 2018-12-10 No data Annual Report Annual Report 2015
0006289484 2018-12-10 No data Annual Report Annual Report 2016

Related by officers

No related officers

Related by address

28 CRESCENT STREET, MIDDLETOWN, CT, 06457, United States

MIDDLESEX HEALTH SERVICES, INC. MIDDLESEX HEALTH SYSTEM, INC. MIDDLESEX HEALTH RESOURCES, INC. MHS PRIMARY CARE, INC. LIFE HEALTH SERVICES, LLC MIDDLESEX LABORATORY PHYSICIANS, LLC

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

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