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  5. FAMILY PRACTICE & INTERNAL MEDICINE, LLC

FAMILY PRACTICE & INTERNAL MEDICINE, LLC

Company Details

Entity Name: FAMILY PRACTICE & INTERNAL MEDICINE, LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 27 Jul 2007
Business ALEI: 0907523
Annual report due: 31 Mar 2025
NAICS code: 621111 - Offices of Physicians (except Mental Health Specialists)
Business address: 52 WASHINGTON AVENUE, NORTH HAVEN, CT, 06473, United States
Mailing address: 451 STATE STREET, UNIT C, NORTH HAVEN, CT, United States, 06473
ZIP code: 06473
County: New Haven
Place of Formation: CONNECTICUT
E-Mail: cmaccounting@caremedica.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAMILY PRACTICE & INTERNAL MEDICINE, LLC 401(K) PROFIT SHARING PLAN 2023 260676766 2024-04-29 FAMILY PRACTICE & INTERNAL MEDICINE, LLC 39
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2036722805
Plan sponsor’s address 52 WASHINGTON AVENUE, SUTE 4, NORTH HAVEN, CT, 06473

Signature of
Role Plan administrator
Date 2024-04-29
Name of individual signing FAUSTO PETRUZZIELLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-04-29
Name of individual signing FAUSTO PETRUZZIELLO
Valid signature Filed with authorized/valid electronic signature
FAMILY PRACTICE & INTERNAL MEDICINE, LLC 401(K) PROFIT SHARING PLAN 2022 260676766 2023-05-15 FAMILY PRACTICE & INTERNAL MEDICINE, LLC 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2036722800
Plan sponsor’s address 52 WASHINGTON AVENUE, SUTE 4, NORTH HAVEN, CT, 06473

Signature of
Role Plan administrator
Date 2023-05-15
Name of individual signing FAUSTO PETRUZZIELLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-05-15
Name of individual signing FAUSTO PETRUZZIELLO
Valid signature Filed with authorized/valid electronic signature
FAMILY PRACTICE & INTERNAL MEDICINE, LLC 401(K) PROFIT SHARING PLAN 2021 260676766 2022-06-24 FAMILY PRACTICE & INTERNAL MEDICINE, LLC 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2036722800
Plan sponsor’s address 52 WASHINGTON AVENUE, SUTE 4, NORTH HAVEN, CT, 06473

Signature of
Role Plan administrator
Date 2022-06-24
Name of individual signing FAUSTO PETRUZZIELLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-06-24
Name of individual signing FAUSTO PETRUZZIELLO
Valid signature Filed with authorized/valid electronic signature
FAMILY PRACTICE & INTERNAL MEDICINE, LLC 401(K) PROFIT SHARING PLAN 2020 260676766 2021-06-22 FAMILY PRACTICE & INTERNAL MEDICINE, LLC 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2036722800
Plan sponsor’s address 52 WASHINGTON AVENUE, SUTE 4, NORTH HAVEN, CT, 06473
FPIM OF SPRING GLEN 401(K) PLAN 2019 061578985 2020-10-05 FAMILY PRACTICE & INTERNAL MEDICINE 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2034076410
Plan sponsor’s address 2200 WHITNEY AVENUE, HAMDEN, CT, 06518
FPIM OF SPRING GLEN 401(K) PLAN 2019 061578985 2020-11-03 FAMILY PRACTICE & INTERNAL MEDICINE 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2034076410
Plan sponsor’s address 2200 WHITNEY AVENUE, HAMDEN, CT, 06518
FAMILY PRACTICE & INTERNAL MEDICINE, LLC 401(K) PROFIT SHARING PLAN 2019 260676766 2020-03-23 FAMILY PRACTICE & INTERNAL MEDICINE, LLC 46
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2036722800
Plan sponsor’s address 52 WASHINGTON AVENUE, SUTE 4, NORTH HAVEN, CT, 06473
FAMILY PRACTICE & INTERNAL MEDICINE, LLC 401(K) PROFIT SHARING PLAN 2018 260676766 2019-09-30 FAMILY PRACTICE & INTERNAL MEDICINE, LLC 51
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2036722800
Plan sponsor’s address 52 WASHINGTON AVENUE, SUTE 4, NORTH HAVEN, CT, 06473
FPIM OF SPRING GLEN 401(K) PLAN 2018 061578985 2019-09-25 FAMILY PRACTICE & INTERNAL MEDICINE 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2034076410
Plan sponsor’s address 2200 WHITNEY AVENUE, HAMDEN, CT, 06518
FPIM OF SPRING GLEN 401(K) PLAN 2017 061578985 2018-10-12 FAMILY PRACTICE & INTERNAL MEDICINE 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-01-01
Business code 621111
Sponsor’s telephone number 2034076410
Plan sponsor’s address 2200 WHITNEY AVENUE, HAMDEN, CT, 06518

Agent

Name Role Business address Mailing address Phone E-Mail Residence address
FAUSTO PETRUZZIELLO MD Agent 52 WASHINGTON AVE, STE 4, NORTH HAVEN, CT, 06473, United States 451 STATE STREET, UNIT C, NORTH HAVEN, CT, 06473, United States +1 203-747-5828 cmaccounting@caremedica.com 29 WINCHESTER DR, NORTH HAVEN, CT, 06473, United States

Officer

Name Role Business address Residence address
FAUSTO PETRUZZIELLO M.D. Officer 52 WASHINGTON AVE, SUITE 4, NORTH HAVEN, CT, 06473, United States 29 WINCHESTER DR, NORTH HAVEN, CT, 06473, United States

License

Credential Credential type Status Status reason Issue date Effective date Expiration date
CLAB.0000911 Clinical Laboratory ACTIVE CURRENT 2015-09-28 2024-04-01 2026-03-31

History

Type Old value New value Date of change
Name change MEDICA PROFESSIONAL ENTERPRISES, LLC FAMILY PRACTICE & INTERNAL MEDICINE, LLC 2010-01-11
Name change FAMILY PRACTICE & INTERNAL MEDICINE, LLC MEDICA PROFESSIONAL ENTERPRISES, LLC 2009-12-30

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012288247 2024-02-05 No data Annual Report Annual Report No data
BF-0011282570 2023-02-08 No data Annual Report Annual Report No data
BF-0010277316 2022-02-16 No data Annual Report Annual Report 2022
0007127543 2021-02-05 No data Annual Report Annual Report 2021
0006779899 2020-02-25 No data Annual Report Annual Report 2020
0006388331 2019-02-18 No data Annual Report Annual Report 2019
0006051985 2018-02-02 No data Annual Report Annual Report 2018
0005897128 2017-07-28 No data Annual Report Annual Report 2017
0005660254 2016-09-29 No data Annual Report Annual Report 2012
0005660281 2016-09-29 No data Annual Report Annual Report 2015

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Related by address

52 WASHINGTON AVENUE, NORTH HAVEN, CT, 06473, United States

AMERICAN MEDICA, LLC IDEAL TECH STAFFING, LLC

451 STATE STREET, UNIT C, NORTH HAVEN, CT, United States, 06473

AMERICAN MEDICA, LLC IDEAL TECH STAFFING, LLC

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

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