SURGICAL ASSOC. OF NEW HAVEN, P.C. EMPLOYEES' PSP
|
2023
|
060858819
|
2024-06-04
|
SURGICAL ASSOCIATES OF NEW HAVEN, P.C.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1972-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037720650
|
Plan sponsor’s
address |
TEMPLE MEDICAL CENTER, 129 YORK STREET, SUITE 1R, NEW HAVEN, CT, 06511
|
Signature of
Role |
Plan administrator |
Date |
2024-06-04 |
Name of individual signing |
KAYE ZUCKERMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-06-04 |
Name of individual signing |
KAYE ZUCKERMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SURGICAL ASSOC. OF NEW HAVEN, P.C. EMPLOYEES' PSP
|
2022
|
060858819
|
2023-07-19
|
SURGICAL ASSOCIATES OF NEW HAVEN, P.C.
|
11
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1972-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037720650
|
Plan sponsor’s
address |
TEMPLE MEDICAL CENTER, 129 YORK STREET, SUITE 1R, NEW HAVEN, CT, 06511
|
Signature of
Role |
Plan administrator |
Date |
2023-07-18 |
Name of individual signing |
KAYE ZUCKERMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-07-18 |
Name of individual signing |
KAYE ZUCKERMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SURGICAL ASSOC. OF NEW HAVEN, P.C. EMPLOYEES' PSP
|
2021
|
060858819
|
2022-04-20
|
SURGICAL ASSOCIATES OF NEW HAVEN, P.C.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1972-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037720650
|
Plan sponsor’s
address |
TEMPLE MEDICAL CENTER, 60 TEMPLE STREET, SUITE 5A, NEW HAVEN, CT, 06510
|
Signature of
Role |
Plan administrator |
Date |
2022-04-20 |
Name of individual signing |
KAYE ZUCKERMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2022-04-20 |
Name of individual signing |
KAYE ZUCKERMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SURGICAL ASSOC. OF NEW HAVEN, P.C. EMPLOYEES' PSP
|
2020
|
060858819
|
2021-09-21
|
SURGICAL ASSOCIATES OF NEW HAVEN, P.C.
|
14
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1972-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037720650
|
Plan sponsor’s
address |
TEMPLE MEDICAL CENTER, 60 TEMPLE STREET, SUITE 5A, NEW HAVEN, CT, 06510
|
Signature of
Role |
Plan administrator |
Date |
2021-09-21 |
Name of individual signing |
PAUL BARCEWICZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2021-09-21 |
Name of individual signing |
PAUL BARCEWICZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SURGICAL ASSOC. OF NEW HAVEN, P.C. EMPLOYEES' PSP
|
2019
|
060858819
|
2020-05-01
|
SURGICAL ASSOCIATES OF NEW HAVEN, P.C.
|
13
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1972-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037720650
|
Plan sponsor’s
address |
TEMPLE MEDICAL CENTER, 60 TEMPLE STREET, SUITE 5A, NEW HAVEN, CT, 06510
|
Signature of
Role |
Plan administrator |
Date |
2020-05-01 |
Name of individual signing |
PAUL BARCEWICZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-05-01 |
Name of individual signing |
PAUL BARCEWICZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SURGICAL ASSOC. OF NEW HAVEN, P.C. EMPLOYEES' PSP
|
2018
|
060858819
|
2019-07-09
|
SURGICAL ASSOCIATES OF NEW HAVEN, P.C.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1972-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037720650
|
Plan sponsor’s
address |
TEMPLE MEDICAL CENTER, 60 TEMPLE STREET, SUITE 5A, NEW HAVEN, CT, 06510
|
Signature of
Role |
Plan administrator |
Date |
2019-07-09 |
Name of individual signing |
PAUL BARCEWICZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-07-09 |
Name of individual signing |
PAUL BARCEWICZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SURGICAL ASSOC. OF NEW HAVEN, P.C. EMPLOYEES' PSP
|
2017
|
060858819
|
2018-07-02
|
SURGICAL ASSOCIATES OF NEW HAVEN, P.C.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1972-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037720650
|
Plan sponsor’s
address |
TEMPLE MEDICAL CENTER, 60 TEMPLE STREET, SUITE 5A, NEW HAVEN, CT, 06510
|
Signature of
Role |
Plan administrator |
Date |
2018-06-29 |
Name of individual signing |
PAUL BARCEWICZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-06-29 |
Name of individual signing |
PAUL BARCEWICZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SURGICAL ASSOC. OF NEW HAVEN, P.C. EMPLOYEES' PSP
|
2016
|
060858819
|
2017-07-13
|
SURGICAL ASSOCIATES OF NEW HAVEN, P.C.
|
12
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1972-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037720650
|
Plan sponsor’s
address |
TEMPLE MEDICAL CENTER, 60 TEMPLE STREET, SUITE 5A, NEW HAVEN, CT, 06510
|
Signature of
Role |
Plan administrator |
Date |
2017-07-13 |
Name of individual signing |
PAUL BARCEWICZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2017-07-13 |
Name of individual signing |
PAUL BARCEWICZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SURGICAL ASSOC. OF NEW HAVEN, P.C. EMPLOYEES' PSP
|
2015
|
060858819
|
2016-05-02
|
SURGICAL ASSOCIATES OF NEW HAVEN, P.C.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1972-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037720650
|
Plan sponsor’s
address |
TEMPLE MEDICAL CENTER, 60 TEMPLE STREET, SUITE 5A, NEW HAVEN, CT, 06510
|
Signature of
Role |
Plan administrator |
Date |
2016-05-02 |
Name of individual signing |
LITA SILVERMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2016-05-02 |
Name of individual signing |
LITA SILVERMAN |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
SURGICAL ASSOC. OF NEW HAVEN, P.C. EMPLOYEES' PSP
|
2014
|
060858819
|
2015-07-21
|
SURGICAL ASSOCIATES OF NEW HAVEN, P.C.
|
10
|
|
File |
View Page
|
Three-digit plan number (PN) |
002
|
Effective date of plan |
1972-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
2037720650
|
Plan sponsor’s
address |
TEMPLE MEDICAL CENTER, 60 TEMPLE STREET, SUITE 5A, NEW HAVEN, CT, 06510
|
Signature of
Role |
Plan administrator |
Date |
2015-07-21 |
Name of individual signing |
PAUL BARCEWICZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2015-07-21 |
Name of individual signing |
PAUL BARCEWICZ |
Valid signature |
Filed with authorized/valid electronic signature |
|
|