MIDDLETOWN SURGICAL GROUP, P.C.

Company Details

Entity Name:	MIDDLETOWN SURGICAL GROUP, P.C.
Jurisdiction:	Connecticut
Legal type:	Stock
Citizenship:	Domestic
Status:	Dissolved
Date Formed:	03 Dec 1970
Date of dissolution:	21 Feb 2017
Business ALEI:	0031211
Annual report due:	29 Dec 2013
Mailing address:	520 SAYBROOK RD, MIDDLETOWN, CT, 06457
Place of Formation:	CONNECTICUT
Total authorized shares:	5000
E-Mail:	sgreenfield@middltownsurg.com

form 5500

Plan Name

Plan Year

EIN/PN

Received

Sponsor

Total number of participants

MIDDLETOWN SURGICAL GROUP, P.C. PROFIT SHARING PLAN

2016

060866794

2017-05-09

MIDDLETOWN SURGICAL GROUP, P.C.

File	View Page
Three-digit plan number (PN)	003
Effective date of plan	1989-11-01
Business code	621111
Sponsor’s telephone number	8603462608
Plan sponsor’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700

Plan administrator’s name and address

Administrator’s EIN	060866794
Plan administrator’s name	MIDDLETOWN SURGICAL GROUP, P.C.
Plan administrator’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700
Administrator’s telephone number	8603462608

MIDDLETOWN SURGICAL GROUP, P.C. PROFIT SHARING PLAN

2015

060866794

2017-05-09

MIDDLETOWN SURGICAL GROUP, P.C.

File	View Page
Three-digit plan number (PN)	003
Effective date of plan	1989-11-01
Business code	621111
Sponsor’s telephone number	8603462608
Plan sponsor’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700

Plan administrator’s name and address

Administrator’s EIN	060866794
Plan administrator’s name	MIDDLETOWN SURGICAL GROUP, P.C.
Plan administrator’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700
Administrator’s telephone number	8603462608

MIDDLETOWN SURGICAL GROUP, P.C. PROFIT SHARING PLAN

2014

060866794

2016-08-15

MIDDLETOWN SURGICAL GROUP, P.C.

File	View Page
Three-digit plan number (PN)	003
Effective date of plan	1989-11-01
Business code	621111
Sponsor’s telephone number	8603462608
Plan sponsor’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700

Plan administrator’s name and address

Administrator’s EIN	060866794
Plan administrator’s name	MIDDLETOWN SURGICAL GROUP, P.C.
Plan administrator’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700
Administrator’s telephone number	8603462608

MIDDLETOWN SURGICAL GROUP, P.C. PROFIT SHARING PLAN

2013

060866794

2015-02-16

MIDDLETOWN SURGICAL GROUP, P.C.

File	View Page
Three-digit plan number (PN)	003
Effective date of plan	1989-11-01
Business code	621111
Sponsor’s telephone number	8603462608
Plan sponsor’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700

Plan administrator’s name and address

Administrator’s EIN	060866794
Plan administrator’s name	MIDDLETOWN SURGICAL GROUP, P.C.
Plan administrator’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700
Administrator’s telephone number	8603462608

Signature of

Role	Plan administrator
Date	2015-02-16
Name of individual signing	PETER ROMEYN
Valid signature	Filed with authorized/valid electronic signature

MIDDLETOWN SURGICAL GROUP, P.C. PROFIT SHARING PLAN

2012

060866794

2014-01-17

MIDDLETOWN SURGICAL GROUP, P.C.

File	View Page
Three-digit plan number (PN)	003
Effective date of plan	1989-11-01
Business code	621111
Sponsor’s telephone number	8603462608
Plan sponsor’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700

Plan administrator’s name and address

Administrator’s EIN	060866794
Plan administrator’s name	MIDDLETOWN SURGICAL GROUP, P.C.
Plan administrator’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700
Administrator’s telephone number	8603462608

Signature of

Role	Plan administrator
Date	2014-01-17
Name of individual signing	PETER ROMEYN
Valid signature	Filed with authorized/valid electronic signature

MIDDLETOWN SURGICAL GROUP, P.C. PROFIT SHARING PLAN

2011

060866794

2013-01-07

MIDDLETOWN SURGICAL GROUP, P.C.

File	View Page
Three-digit plan number (PN)	003
Effective date of plan	1989-11-01
Business code	621111
Sponsor’s telephone number	8603462608
Plan sponsor’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700

Plan administrator’s name and address

Administrator’s EIN	060866794
Plan administrator’s name	MIDDLETOWN SURGICAL GROUP, P.C.
Plan administrator’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700
Administrator’s telephone number	8603462608

Signature of

Role	Plan administrator
Date	2013-01-07
Name of individual signing	PETER ROMEYN
Valid signature	Filed with authorized/valid electronic signature

MIDDLETOWN SURGICAL GROUP, P.C. PROFIT SHARING PLAN

2010

060866794

2011-12-15

MIDDLETOWN SURGICAL GROUP, P.C.

Three-digit plan number (PN)	003
Effective date of plan	1989-11-01
Business code	621111
Sponsor’s telephone number	8603462608
Plan sponsor’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700

Plan administrator’s name and address

Administrator’s EIN	060866794
Plan administrator’s name	MIDDLETOWN SURGICAL GROUP, P.C.
Plan administrator’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700
Administrator’s telephone number	8603462608

Signature of

Role	Plan administrator
Date	2011-12-15
Name of individual signing	WILLIAM LONGO, M.D.
Valid signature	Filed with authorized/valid electronic signature

MIDDLETOWN SURGICAL GROUP, P.C. PROFIT SHARING PLAN

2010

060866794

2011-12-16

MIDDLETOWN SURGICAL GROUP, P.C.

File	View Page
Three-digit plan number (PN)	003
Effective date of plan	1989-11-01
Business code	621111
Sponsor’s telephone number	8603462608
Plan sponsor’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700

Plan administrator’s name and address

Administrator’s EIN	060866794
Plan administrator’s name	MIDDLETOWN SURGICAL GROUP, P.C.
Plan administrator’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700
Administrator’s telephone number	8603462608

Signature of

Role	Plan administrator
Date	2011-12-16
Name of individual signing	WILLIAM LONGO, M.D.
Valid signature	Filed with authorized/valid electronic signature

MIDDLETOWN SURGICAL GROUP, P.C. PROFIT SHARING PLAN

2010

060866794

2011-01-10

MIDDLETOWN SURGICAL GROUP, P.C.

Three-digit plan number (PN)	003
Effective date of plan	1989-11-01
Business code	621111
Sponsor’s telephone number	8603462608
Plan sponsor’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700

Plan administrator’s name and address

Administrator’s EIN	060866794
Plan administrator’s name	MIDDLETOWN SURGICAL GROUP, P.C.
Plan administrator’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700
Administrator’s telephone number	8603462608

Signature of

Role	Plan administrator
Date	2011-01-10
Name of individual signing	DAVID WETSMAN
Valid signature	Filed with authorized/valid electronic signature

MIDDLETOWN SURGICAL GROUP, P.C. PROFIT SHARING PLAN

2010

060866794

2011-01-10

MIDDLETOWN SURGICAL GROUP, P.C.

Three-digit plan number (PN)	003
Effective date of plan	1989-11-01
Business code	621111
Sponsor’s telephone number	8603462608
Plan sponsor’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700

Plan administrator’s name and address

Administrator’s EIN	060866794
Plan administrator’s name	MIDDLETOWN SURGICAL GROUP, P.C.
Plan administrator’s address	520 SAYBROOK ROAD, SUITE S100, MIDDLETOWN, CT, 064574700
Administrator’s telephone number	8603462608

Signature of

Role	Plan administrator
Date	2011-01-10
Name of individual signing	DAVID WETSMAN
Valid signature	Filed with authorized/valid electronic signature

Agent

Name	Role	Business address	E-Mail	Residence address
DONALD MCKAY	Agent	520 SAYBROOK DR, MIDDLETOWN, CT, 06457, United States	sgreenfield@middltownsurg.com	116 BRITTON RD, MIDDLETOWN, CT, 06457, United States

Officer

Name	Role	Business address	Residence address
ANDREA M. MALON M.D.	Officer	520 SAYBROOK RD, MIDDLETOWN, CT, 06457, United States	862 ARBUTUS ST., MIDDLETOWN, CT, 06457, United States
PETER S. ROMEYN MD	Officer	520 SAYBROOK ROAD, MIDDLETOWN, CT, 06457, United States	22 PATTERSON LANE, DURHAM, CT, 06422, United States

Filing

Filing number	Filing date	Effective date	Filing category	Filing type	Report year
0005772949	2017-02-21	2017-02-21	Dissolution	Certificate of Dissolution	No data
0004999383	2013-12-12	No data	Annual Report	Annual Report	2012
0004664647	2011-12-21	No data	Annual Report	Annual Report	2011
0004357639	2010-12-20	No data	Annual Report	Annual Report	2010
0004090895	2009-12-09	No data	Annual Report	Annual Report	2009
0003855221	2008-12-18	No data	Annual Report	Annual Report	2005
0003855223	2008-12-18	No data	Annual Report	Annual Report	2007
0003855222	2008-12-18	No data	Annual Report	Annual Report	2006
0003855220	2008-12-18	No data	Annual Report	Annual Report	2004
0003855218	2008-12-18	No data	Annual Report	Annual Report	2002
0003855219	2008-12-18	No data	Annual Report	Annual Report	2003
0003855226	2008-12-18	No data	Annual Report	Annual Report	2008
0002366710	2002-01-15	2002-01-15	Annual Report	Annual Report	2001
0002366709	2002-01-15	2002-01-15	Annual Report	Annual Report	2000
0002366705	2002-01-15	2002-01-15	Annual Report	Annual Report	1997
0002366704	2002-01-15	2002-01-15	Annual Report	Annual Report	1996
0002366707	2002-01-15	2002-01-15	Annual Report	Annual Report	1999
0002366706	2002-01-15	2002-01-15	Annual Report	Annual Report	1998
0002366703	2002-01-15	2002-01-15	Annual Report	Annual Report	1995
0001549752	1995-08-17	No data	Additional Principal	Additional Principal	No data

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

MIDDLETOWN SURGICAL GROUP, P.C.

Company Details

form 5500

Agent

Officer

Filing

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