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  5. PULMONARY SPECIALTIES, P.C.

PULMONARY SPECIALTIES, P.C.

Company Details

Entity Name: PULMONARY SPECIALTIES, P.C.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 20 Jun 2007
Business ALEI: 0902872
Annual report due: 20 Jun 2025
NAICS code: 621111 - Offices of Physicians (except Mental Health Specialists)
Business address: PULMONARY SPECIALTIES, PC 130 DIVISION ST 130 DIVISION ST, DERBY, CT, 06418, United States
Mailing address: PULMONARY SPECIALTIES, PC130 Division Street, DERBY, CT, United States, 06418
ZIP code: 06418
County: New Haven
Place of Formation: CONNECTICUT
Total authorized shares: 20000
E-Mail: kimberly_conlon@hotmail.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PULMONARY SPECIALTIES, P.C. 401(K) PLAN 2023 260264231 2024-09-24 PULMONARY SPECIALTIES, P.C. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2037327573
Plan sponsor’s address GRIFFIN HOSPITAL, 130 DIVISION ST, DERBY, CT, 06418

Signature of
Role Plan administrator
Date 2024-09-24
Name of individual signing KATHLEEN CHAISSON
Valid signature Filed with authorized/valid electronic signature
PULMONARY SPECIALTIES, P.C. 401(K) PLAN 2022 260264231 2023-09-19 PULMONARY SPECIALTIES, P.C. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2037327573
Plan sponsor’s address GRIFFIN HOSPITAL, 130 DIVISION ST, DERBY, CT, 06418

Signature of
Role Plan administrator
Date 2023-09-19
Name of individual signing KATHLEEN CHAISSON
Valid signature Filed with authorized/valid electronic signature
PULMONARY SPECIALTIES, P.C. 401(K) PLAN 2021 260264231 2022-10-11 PULMONARY SPECIALTIES, P.C. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2037327573
Plan sponsor’s address 130 DIVISION STREET, DERBY, CT, 06418

Signature of
Role Plan administrator
Date 2022-10-11
Name of individual signing KATHLEEN CHAISSON
Valid signature Filed with authorized/valid electronic signature
PULMONARY SPECIALTIES, P.C. 401(K) PLAN 2020 260264231 2021-09-24 PULMONARY SPECIALTIES, P.C. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2037327573
Plan sponsor’s address 130 DIVISION STREET, DERBY, CT, 06418

Signature of
Role Plan administrator
Date 2021-09-24
Name of individual signing KATHLEEN CHAISSON
Valid signature Filed with authorized/valid electronic signature
PULMONARY SPECIALTIES, P.C. 401(K) PLAN 2019 260264231 2020-09-23 PULMONARY SPECIALTIES, P.C. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2037327573
Plan sponsor’s address 130 DIVISION STREET, DERBY, CT, 06418
PULMONARY SPECIALTIES, P.C. 401(K) PLAN 2018 260264231 2019-10-10 PULMONARY SPECIALTIES, P.C. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2037327573
Plan sponsor’s address 130 DIVISION STREET, DERBY, CT, 06418
PULMONARY SPECIALTIES, P.C. 401(K) PLAN 2017 260264231 2018-09-25 PULMONARY SPECIALTIES, P.C. 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2037327573
Plan sponsor’s address 130 DIVISION STREET, DERBY, CT, 06418
PULMONARY SPECIALTIES, P.C. 401(K) PLAN 2016 260264231 2017-08-28 PULMONARY SPECIALTIES, P.C. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2037327573
Plan sponsor’s address 130 DIVISION STREET, DERBY, CT, 06418
PULMONARY SPECIALTIES, P.C. 401(K) PLAN 2015 260264231 2016-09-16 PULMONARY SPECIALTIES, P.C. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2037327573
Plan sponsor’s address 130 DIVISION STREET, DERBY, CT, 06418
PULMONARY SPECIALTIES, P.C. 401(K) PLAN 2014 260264231 2015-09-10 PULMONARY SPECIALTIES, P.C. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621399
Sponsor’s telephone number 2037327573
Plan sponsor’s address 130 DIVISION STREET, DERBY, CT, 06418

Signature of
Role Plan administrator
Date 2015-09-10
Name of individual signing KENNETH DOBULER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Mailing address Phone E-Mail Residence address
KATHLEEN M. CHAISSON M.D. Agent 130 DIVISION STREET, DERBY, CT, 06418, United States 130 DIVISION STREET, OXFORD, CT, 06418, United States +1 203-906-2309 kimberly_conlon@hotmail.com 35 FIDDLEHEAD ROAD, OXFORD, CT, 06478, United States

Officer

Name Role Business address Phone E-Mail Residence address
KATHLEEN M. CHAISSON M.D. Officer C/O THE GRIFFIN HOSPITAL, 130 DIVISION ST, DERBY, CT, 06418, United States +1 203-906-2309 kimberly_conlon@hotmail.com 35 FIDDLEHEAD ROAD, OXFORD, CT, 06478, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012352913 2024-08-27 No data Annual Report Annual Report No data
BF-0011281206 2023-09-21 No data Annual Report Annual Report No data
BF-0010801164 2023-09-21 No data Annual Report Annual Report No data
BF-0009754483 2023-09-21 No data Annual Report Annual Report No data
BF-0011951182 2023-08-30 No data Administrative Dissolution Notice of Intent to Dissolve/Revoke No data
0007026514 2020-11-25 No data Interim Notice Interim Notice No data
0007023382 2020-11-20 No data Interim Notice Interim Notice No data
0006995879 2020-10-05 No data Annual Report Annual Report 2019
0006995867 2020-10-05 No data Annual Report Annual Report 2017
0006995865 2020-10-05 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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