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  5. INTERNAL MEDICINE OF WEST HAVEN, LLC

INTERNAL MEDICINE OF WEST HAVEN, LLC

Company Details

Entity Name: INTERNAL MEDICINE OF WEST HAVEN, LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 26 Dec 2002
Business ALEI: 0734883
Annual report due: 31 Mar 2025
NAICS code: 621111 - Offices of Physicians (except Mental Health Specialists)
Business address: 764 CAMPBELL AVENUE SUITE E, WEST HAVEN, CT, 06516, United States
Mailing address: 764 CAMPBELL AVENUE SUITE E, WEST HAVEN, CT, United States, 06516
ZIP code: 06516
County: New Haven
Place of Formation: CONNECTICUT
E-Mail: piyush@sevihealth.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
INTERNAL MEDICINE OF WEST HAVEN, LLC SECTION 401(K) PROFIT SHARING PLAN 2022 320048568 2023-06-07 INTERNAL MEDICINE OF WEST HAVEN, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-03-01
Business code 621111
Sponsor’s telephone number 2039310034
Plan sponsor’s address 764 CAMPBELL AVENUE SUITE E, WEST HAVEN, CT, 06516
INTERNAL MEDICINE OF WEST HAVEN, LLC SECTION 401(K) PROFIT SHARING PLAN 2021 320048568 2022-06-14 INTERNAL MEDICINE OF WEST HAVEN, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-03-01
Business code 621111
Sponsor’s telephone number 2039310034
Plan sponsor’s address 764 CAMPBELL AVENUE SUITE E, WEST HAVEN, CT, 06516

Signature of
Role Plan administrator
Date 2022-06-14
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-06-14
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
INTERNAL MEDICINE OF WEST HAVEN, LLC SECTION 401(K) PROFIT SHARING PLAN 2020 320048568 2021-06-02 INTERNAL MEDICINE OF WEST HAVEN, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-03-01
Business code 621111
Sponsor’s telephone number 2039310034
Plan sponsor’s address 764 CAMPBELL AVENUE SUITE E, WEST HAVEN, CT, 06516

Signature of
Role Plan administrator
Date 2021-05-28
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-05-28
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
INTERNAL MEDICINE OF WEST HAVEN, LLC SECTION 401(K) PROFIT SHARING PLAN 2019 320048568 2020-07-01 INTERNAL MEDICINE OF WEST HAVEN, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-03-01
Business code 621111
Sponsor’s telephone number 2039310034
Plan sponsor’s address 764 CAMPBELL AVENUE SUITE E, WEST HAVEN, CT, 06516

Signature of
Role Plan administrator
Date 2020-07-01
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-01
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
INTERNAL MEDICINE OF WEST HAVEN, LLC DEFINED BENEFIT PLAN 2019 320048568 2020-07-16 INTERNAL MEDICINE OF WEST HAVEN, LLC 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2039310034
Plan sponsor’s address 764 CAMPBELL AVENUE SUITE E, WEST HAVEN, CT, 06516

Signature of
Role Plan administrator
Date 2020-07-16
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-16
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
INTERNAL MEDICINE OF WEST HAVEN, LLC DEFINED BENEFIT PLAN 2018 320048568 2019-09-25 INTERNAL MEDICINE OF WEST HAVEN, LLC 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2039310034
Plan sponsor’s address 764 CAMPBELL AVENUE SUITE E, WEST HAVEN, CT, 06516

Signature of
Role Plan administrator
Date 2019-09-25
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-25
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
INTERNAL MEDICINE OF WEST HAVEN, LLC SECTION 401(K) PROFIT SHARING PLAN 2018 320048568 2019-05-28 INTERNAL MEDICINE OF WEST HAVEN, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-03-01
Business code 621111
Sponsor’s telephone number 2039310034
Plan sponsor’s address 764 CAMPBELL AVENUE SUITE E, WEST HAVEN, CT, 06516

Signature of
Role Plan administrator
Date 2019-05-24
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-05-24
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
INTERNAL MEDICINE OF WEST HAVEN, LLC SECTION 401(K) PROFIT SHARING PLAN 2017 320048568 2018-05-24 INTERNAL MEDICINE OF WEST HAVEN, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-03-01
Business code 621111
Sponsor’s telephone number 2039310034
Plan sponsor’s address 764 CAMPBELL AVENUE SUITE E, WEST HAVEN, CT, 06516

Signature of
Role Plan administrator
Date 2018-05-21
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-21
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
INTERNAL MEDICINE OF WEST HAVEN, LLC DEFINED BENEFIT PLAN 2017 320048568 2018-10-03 INTERNAL MEDICINE OF WEST HAVEN, LLC 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2039310034
Plan sponsor’s address 764 CAMPBELL AVENUE SUITE E, WEST HAVEN, CT, 06516

Signature of
Role Plan administrator
Date 2018-10-03
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-10-03
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
INTERNAL MEDICINE OF WEST HAVEN, LLC DEFINED BENEFIT PLAN 2016 320048568 2017-07-11 INTERNAL MEDICINE OF WEST HAVEN, LLC 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2039310034
Plan sponsor’s address 764 CAMPBELL AVENUE SUITE E, WEST HAVEN, CT, 06516

Signature of
Role Plan administrator
Date 2017-07-10
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-10
Name of individual signing MANGALA GOTTIPARTHY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
C T CORPORATION SYSTEM Agent

Officer

Name Role Business address Residence address
Piyush Gupta Officer 764 CAMPBELL AVENUE SUITE E, WEST HAVEN, CT, 06516, United States 764 CAMPBELL AVENUE SUITE E, WEST HAVEN, CT, 06516, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012087800 2024-03-30 No data Annual Report Annual Report No data
BF-0011739011 2023-03-14 2023-03-14 Change of Agent Agent Change No data
BF-0011269410 2023-01-05 No data Annual Report Annual Report No data
BF-0010795261 2022-11-08 No data Annual Report Annual Report No data
BF-0009894982 2022-11-08 No data Annual Report Annual Report No data
BF-0009667909 2022-11-08 No data Annual Report Annual Report 2020
0006346066 2019-01-30 No data Annual Report Annual Report 2014
0006346092 2019-01-30 No data Annual Report Annual Report 2015
0006346135 2019-01-30 No data Annual Report Annual Report 2018
0006346104 2019-01-30 No data Annual Report Annual Report 2016

Related by officers

Piyush Gupta

LRMN Consulting, LLC SEVI HEALTH CT CLOVER, PC.

Related by address

No related companies by address

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

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