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  5. CANDLEWOOD VALLEY PEDIATRICS, P.C.

CANDLEWOOD VALLEY PEDIATRICS, P.C.

Company Details

Entity Name: CANDLEWOOD VALLEY PEDIATRICS, P.C.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 08 Jun 2000
Business ALEI: 0652775
Annual report due: 08 Jun 2025
NAICS code: 621111 - Offices of Physicians (except Mental Health Specialists)
Business address: 120 PARK LANE RD STE A-101, NEW MILFORD, CT, 06776, United States
Mailing address: 120 PARK LANE RD STE A-101, NEW MILFORD, CT, United States, 06776
ZIP code: 06776
County: Litchfield
Place of Formation: CONNECTICUT
Total authorized shares: 5000
E-Mail: billing@cvpkids.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CANDLEWOOD VALLEY PEDIATRICS PROFIT SHARING PLAN 2023 061585163 2024-10-09 CANDLEWOOD VALLEY PEDIATRICS, P.C. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 8603558190
Plan sponsor’s address 120 PARK LANE, SUITE A101, NEW MILFORD, CT, 06776
CANDLEWOOD VALLEY PEDIATRICS PROFIT SHARING PLAN 2022 061585163 2023-05-25 CANDLEWOOD VALLEY PEDIATRICS, P.C. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 8603558190
Plan sponsor’s address 120 PARK LANE, SUITE A101, NEW MILFORD, CT, 06776

Signature of
Role Plan administrator
Date 2023-05-25
Name of individual signing EVAN HACK, M.D.
Valid signature Filed with authorized/valid electronic signature
CANDLEWOOD VALLEY PEDIATRICS PROFIT SHARING PLAN 2021 061585163 2022-04-13 CANDLEWOOD VALLEY PEDIATRICS, P.C. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 8603558190
Plan sponsor’s address 120 PARK LANE, SUITE A101, NEW MILFORD, CT, 06776

Signature of
Role Plan administrator
Date 2022-04-13
Name of individual signing EVAN HACK, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-04-13
Name of individual signing EVAN HACK, M.D.
Valid signature Filed with authorized/valid electronic signature
CANDLEWOOD VALLEY PEDIATRICS PROFIT SHARING PLAN 2020 061585163 2021-04-07 CANDLEWOOD VALLEY PEDIATRICS, P.C. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 8603558190
Plan sponsor’s address 120 PARK LANE, SUITE A101, NEW MILFORD, CT, 06776

Signature of
Role Plan administrator
Date 2021-04-07
Name of individual signing EVAN HACK, M.D.
Valid signature Filed with authorized/valid electronic signature
CANDLEWOOD VALLEY PEDIATRICS PROFIT SHARING PLAN 2019 061585163 2020-03-24 CANDLEWOOD VALLEY PEDIATRICS, P.C. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 8603558190
Plan sponsor’s address 120 PARK LANE, SUITE A101, NEW MILFORD, CT, 06776

Signature of
Role Plan administrator
Date 2020-03-24
Name of individual signing EVAN HACK, M.D.
Valid signature Filed with authorized/valid electronic signature
CANDLEWOOD VALLEY PEDIATRICS PROFIT SHARING PLAN 2018 061585163 2019-05-20 CANDLEWOOD VALLEY PEDIATRICS, P.C. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 8603558190
Plan sponsor’s address 120 PARK LANE, SUITE A101, NEW MILFORD, CT, 06776

Signature of
Role Plan administrator
Date 2019-05-20
Name of individual signing EVAN HACK, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-05-20
Name of individual signing EVAN R HACK
Valid signature Filed with authorized/valid electronic signature
CANDLEWOOD VALLEY PEDIATRICS PROFIT SHARING PLAN 2017 061585163 2018-06-19 CANDLEWOOD VALLEY PEDIATRICS, P.C. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 8603558190
Plan sponsor’s address 120 PARK LANE, SUITE A101, NEW MILFORD, CT, 06776

Signature of
Role Plan administrator
Date 2018-06-19
Name of individual signing EVAN HACK, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-06-19
Name of individual signing EVAN HACK
Valid signature Filed with authorized/valid electronic signature
CANDLEWOOD VALLEY PEDIATRICS PROFIT SHARING PLAN 2016 061585163 2017-06-28 CANDLEWOOD VALLEY PEDIATRICS, P.C. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 8603558190
Plan sponsor’s address 120 PARK LANE, SUITE A101, NEW MILFORD, CT, 06776

Signature of
Role Plan administrator
Date 2017-06-28
Name of individual signing EVAN HACK, M.D.
Valid signature Filed with authorized/valid electronic signature
CANDLEWOOD VALLEY PEDIATRICS PROFIT SHARING PLAN 2015 061585163 2016-04-12 CANDLEWOOD VALLEY PEDIATRICS, P.C. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 8603558190
Plan sponsor’s address 120 PARK LANE, SUITE A101, NEW MILFORD, CT, 06776

Signature of
Role Plan administrator
Date 2016-04-12
Name of individual signing EVAN HACK, M.D.
Valid signature Filed with authorized/valid electronic signature
CANDLEWOOD VALLEY PEDIATRICS PROFIT SHARING PLAN 2014 061585163 2015-04-24 CANDLEWOOD VALLEY PEDIATRICS, P.C. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 8603558190
Plan sponsor’s address 120 PARK LANE, SUITE A101, NEW MILFORD, CT, 06776

Signature of
Role Plan administrator
Date 2015-04-24
Name of individual signing EVAN HACK, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
REID AND RIEGE, P.C. Agent

Officer

Name Role Business address Residence address
FRANK FANELLA JR MD Officer 120 PARK LANE RD, STE A-101, NEW MILFORD, CT, 06776, United States 11 MOCKINGBIRD LANE, NEW MILFORD, CT, 06776, United States
MATTHEW G. ABEL M.D. Officer 120 PARK LANE RD, STE A-101, NEW MILFORD, CT, 06776, United States 9 MIA BELLA DR, NEW MILFORD, CT, 06776, United States
EVAN R. HACK Officer 120 PARK LANE RD, STE A-101, NEW MILFORD, CT, 06776, United States 47 PUTNAM RD, NEW MILFORD, CT, 06776, United States
KRISTI F. BECK Officer 120 PARK LANE RD, STE A-101, NEW MILFORD, CT, 06776, United States 29 WOOD CREEK RD, NEW MILFORD, CT, 06776, United States
STEPHANIE T. TISO Officer 120 PARK LANE RD, STE A-101, NEW MILFORD, CT, 06776, United States 42 MARNEY DRIVE, MIDDLEBURY, CT, 06762, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012152259 2024-06-03 No data Annual Report Annual Report No data
BF-0011397587 2023-05-09 No data Annual Report Annual Report No data
BF-0010400741 2022-05-12 No data Annual Report Annual Report 2022
BF-0009752062 2021-07-08 No data Annual Report Annual Report No data
0006902191 2020-05-11 No data Annual Report Annual Report 2020
0006572576 2019-06-11 No data Annual Report Annual Report 2019
0006288492 2018-12-06 No data Annual Report Annual Report 2018
0005850400 2017-05-25 No data Annual Report Annual Report 2017
0005589331 2016-06-20 2016-06-20 Amendment Restated No data
0005575559 2016-05-26 No data Annual Report Annual Report 2016

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Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

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