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ENFIELD PEDIATRIC ASSOCIATES, P.C.

Company Details

Entity Name: ENFIELD PEDIATRIC ASSOCIATES, P.C.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Dissolved
Date Formed: 29 Apr 2011
Date of dissolution: 31 Dec 2016
Business ALEI: 1036623
Annual report due: 28 Apr 2012
Business address: 155 HAZARD AVENUE SUITE 14, ENFIELD, CT, 06082
ZIP code: 06082
County: Hartford
Place of Formation: CONNECTICUT
Total authorized shares: 100

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ENFIELD PEDIATRIC ASSOCIATES 401 K PROFIT SHARING PLAN TRUST 2016 452559642 2017-07-27 ENFIELD PEDIATRIC ASSOCIATES 19
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2007-02-01
Business code 621111
Sponsor’s telephone number 8607493169
Plan sponsor’s address 155 HAZARD AVE STE 14, ENFIELD, CT, 060824586

Signature of

Role Plan administrator
Date 2017-07-27
Name of individual signing ROSS PORTER
Valid signature Filed with authorized/valid electronic signature
ENFIELD PEDIATRIC ASSOCIATES 401-K PROFIT SHARING PLAN & TRUST 2015 452559642 2016-09-02 ENFIELD PEDIATRIC ASSOCIATES 19
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2007-02-01
Business code 621111
Sponsor’s telephone number 8607493169
Plan sponsor’s address 155 HAZARD AVENUE, SUITE 14, ENFIELD, CT, 06082

Signature of

Role Plan administrator
Date 2016-09-02
Name of individual signing ROSS PORTER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-09-02
Name of individual signing ROSS PORTER
Valid signature Filed with authorized/valid electronic signature
ENFIELD PEDIATRIC ASSOCIATES 401-K PROFIT SHARING PLAN & TRUST 2014 452559642 2016-09-02 ENFIELD PEDIATRIC ASSOCIATES 19
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2007-02-01
Business code 621111
Sponsor’s telephone number 8607493169
Plan sponsor’s address 155 HAZARD AVENUE, ENFIELD, CT, 06082

Signature of

Role Plan administrator
Date 2016-09-02
Name of individual signing ROSS PORTER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-09-02
Name of individual signing ROSS PORTER
Valid signature Filed with authorized/valid electronic signature
ENFIELD PEDIATRIC ASSOCIATES 401 K PROFIT SHARING PLAN TRUST 2013 452559642 2014-07-28 ENFIELD PEDIATRIC ASSOCIATES 20
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2007-02-01
Business code 621111
Sponsor’s telephone number 8607493169
Plan sponsor’s address 155 HAZARD AVE STE 14, ENFIELD, CT, 060824586

Signature of

Role Plan administrator
Date 2014-07-28
Name of individual signing ROSS W PORTER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Residence address
ROSS PORTER M.D. Agent 155 HAZARD AVENUE, SUITE 14, ENFIELD, CT, 06082, United States 65 LANCE DRIVE, SOMERS, CT, 06071, United States

Officer

Name Role Business address Residence address
ROSS PORTER M.D. Officer 155 HAZARD AVENUE, SUITE 14, ENFIELD, CT, 06082, United States 65 LANCE DRIVE, SOMERS, CT, 06071, United States

License

Credential Credential type Status Status reason Issue date Effective date Expiration date
CSP.0025917 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER INACTIVE No data No data 1997-08-11 1998-02-28
1.036234 Physician/Surgeon INACTIVE LAPSED DUE TO NON-RENEWAL 1997-07-25 No data 1998-01-31

Filing

Filing number Filing date Effective date Filing category Filing type Report year
0005728523 2016-12-31 2016-12-31 Dissolution Certificate of Dissolution No data
0004366895 2011-04-29 2011-04-29 First Report Organization and First Report No data
0004366882 2011-04-29 No data Business Formation Certificate of Incorporation No data

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website