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FAIRFIELD DERMATOLOGY, P.C.

Company Details

Entity Name: FAIRFIELD DERMATOLOGY, P.C.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 21 Dec 1978
Business ALEI: 0085837
Annual report due: 21 Dec 2024
NAICS code: 621111 - Offices of Physicians (except Mental Health Specialists)
Business address: 1305 POST ROAD STE 310, FAIRFIELD, CT, 06824, United States
Mailing address: 1305 POST ROAD STE 310, FAIRFIELD, CT, United States, 06824
ZIP code: 06824
County: Fairfield
Place of Formation: CONNECTICUT
Total authorized shares: 1000
E-Mail: DBENITEZ@FAIRFIELDDERM.COM

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAIRFIELD DERMATOLOGY, P.C. EMPLOYEES' PROFIT SHARING PLAN AND TRUST 2023 061000363 2024-10-04 FAIRFIELD DERMATOLOGY, P.C. 41
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-01-01
Business code 621111
Sponsor’s telephone number 2032597709
Plan sponsor’s address 1305 POST RD., STE. 310, FAIRFIELD, CT, 068246016
FAIRFIELD DERMATOLOGY, P.C. EMPLOYEES' PROFIT SHARING PLAN AND TRUST 2022 061000363 2023-10-05 FAIRFIELD DERMATOLOGY, P.C. 37
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-01-01
Business code 621111
Sponsor’s telephone number 2032597709
Plan sponsor’s address 1305 POST RD., STE. 310, FAIRFIELD, CT, 068246016
FAIRFIELD DERMATOLOGY, P.C. EMPLOYEES' PROFIT SHARING PLAN AND TRUST 2021 061000363 2022-09-29 FAIRFIELD DERMATOLOGY, P.C. 33
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-01-01
Business code 621111
Sponsor’s telephone number 2032597709
Plan sponsor’s address 1305 POST RD., STE. 310, FAIRFIELD, CT, 068246016
FAIRFIELD DERMATOLOGY, P.C. EMPLOYEES' PROFIT SHARING PLAN AND TRUST 2020 061000363 2021-07-15 FAIRFIELD DERMATOLOGY, P.C. 30
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-01-01
Business code 621111
Sponsor’s telephone number 2032597709
Plan sponsor’s address 1305 POST RD., STE. 310, FAIRFIELD, CT, 068246016
FAIRFIELD DERMATOLOGY, P.C. EMPLOYEES' PROFIT SHARING PLAN AND TRUST 2019 061000363 2020-10-13 FAIRFIELD DERMATOLOGY, P.C. 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-01-01
Business code 621111
Sponsor’s telephone number 2032597709
Plan sponsor’s address 1305 POST RD., STE. 310, FAIRFIELD, CT, 068246016
FAIRFIELD DERMATOLOGY, P.C. EMPLOYEES' PROFIT SHARING PLAN AND TRUST 2018 061000363 2019-06-28 FAIRFIELD DERMATOLOGY, P.C. 20
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-01-01
Business code 621111
Sponsor’s telephone number 2032597709
Plan sponsor’s address 1305 POST RD., STE. 310, FAIRFIELD, CT, 068246016
FAIRFIELD DERMATOLOGY, P.C. EMPLOYEES' PROFIT SHARING PLAN AND TRUST 2017 061000363 2018-06-07 FAIRFIELD DERMATOLOGY, P.C. 25
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-01-01
Business code 621111
Sponsor’s telephone number 2032597709
Plan sponsor’s address 1305 POST RD., STE. 310, FAIRFIELD, CT, 068246016
IVAN S. COHEN, M.D., P.C. EMPLOYEES' PROFIT SHARING PLAN AND TRUST 2016 061000363 2017-08-03 IVAN S. COHEN, M.D., P.C. 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-01-01
Business code 621111
Sponsor’s telephone number 2032597709
Plan sponsor’s address 1305 POST RD STE 310, FAIRFIELD, CT, 068246016
IVAN S. COHEN, M.D., P.C. EMPLOYEES' PROFIT SHARING PLAN AND TRUST 2015 061000363 2016-09-02 IVAN S. COHEN, M.D., P.C. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-01-01
Business code 621111
Sponsor’s telephone number 2032597709
Plan sponsor’s address 1305 POST RD STE 310, FAIRFIELD, CT, 068246016
IVAN S. COHEN, M.D., P.C. EMPLOYEES' PROFIT SHARING PLAN AND TRUST 2014 061000363 2015-08-21 IVAN S. COHEN, M.D., P.C. 16
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-01-01
Business code 621111
Sponsor’s telephone number 2032597709
Plan sponsor’s address 1305 POST RD STE 310, FAIRFIELD, CT, 068246016

Signature of

Role Plan administrator
Date 2015-08-21
Name of individual signing IVAN S. COHEN, PRESIDENT
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Mailing address Phone E-Mail Residence address
DANIELA BENITEZ Agent 1305 POST ROAD, SUITE 310, FAIRFIELD, CT, 06824, United States 1305 POST ROAD, SUITE 310, FAIRFIELD, CT, 06824, United States +1 516-338-8700 pvesely@shalikmorris.com 1305 POST ROAD, SUITE 310, FAIRFIELD, CT, 06824, United States

Officer

Name Role Business address Residence address
Elizabeth Smith Officer 1305 Post Rd, 310, Fairfield, CT, 06824-6016, United States 445 Hope St, 7, Stamford, CT, 06906-1311, United States
Jason McBean Officer 1305 Post Rd, 310, Fairfield, CT, 06824-6016, United States 1305 Post Rd, 310, Fairfield, CT, 06824-6016, United States

License

Credential Credential type Status Status reason Issue date Effective date Expiration date
CLAB.0001104 Clinical Laboratory ACTIVE CURRENT 2023-09-11 2023-09-11 2025-09-30

History

Type Old value New value Date of change
Name change IVAN S. COHEN, M.D.,P.C. FAIRFIELD DERMATOLOGY, P.C. 2017-10-31

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0011078678 2023-12-15 No data Annual Report Annual Report No data
BF-0010236490 2022-11-22 No data Annual Report Annual Report 2022
BF-0010621291 2022-06-03 2022-06-03 Interim Notice Interim Notice No data
BF-0009829118 2021-11-30 No data Annual Report Annual Report No data
0007041836 2020-12-21 No data Annual Report Annual Report 2020
0007013123 2020-11-04 No data Annual Report Annual Report 2019
0007013094 2020-11-04 No data Annual Report Annual Report 2015
0007013095 2020-11-04 No data Annual Report Annual Report 2016
0007013093 2020-11-04 No data Annual Report Annual Report 2014
0007013116 2020-11-04 No data Annual Report Annual Report 2018

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website