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MODERN DERMATOLOGY P.C.

Company Details

Entity Name: MODERN DERMATOLOGY P.C.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Active
Date Formed: 14 Nov 2017 (Companies founded in November 2017)
Business ALEI: 1255435
Annual report due: 13 Apr 2025
NAICS code: 622110 - General Medical and Surgical Hospitals
Business address: 1032 POST ROAD EAST, WESTPORT, CT, 06880, United States
Mailing address: 1032 POST ROAD EAST, WESTPORT, CT, United States, 06880
ZIP code: 06880 (Companies in Fairfield, 06880)
County: Fairfield
Place of Formation: CONNECTICUT
Total authorized shares: 20000
E-Mail: cporto@pppclaw.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MODERN DERMATOLOGY 401(K) PLAN 2023 823640208 2024-05-13 MODERN DERMATOLOGY, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 2036350770
Plan sponsor’s address 1032 POST ROAD EAST, WESTPORT, CT, 06880

Signature of

Role Plan administrator
Date 2024-05-14
Name of individual signing RHONDA KLEIN
Valid signature Filed with authorized/valid electronic signature
MODERN DERMATOLOGY 401(K) PLAN 2022 823640208 2023-03-22 MODERN DERMATOLOGY, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 2036350770
Plan sponsor’s address 1032 POST ROAD EAST, WESTPORT, CT, 06880

Signature of

Role Plan administrator
Date 2023-03-22
Name of individual signing RHONDA KLEIN
Valid signature Filed with authorized/valid electronic signature
MODERN DERMATOLOGY 401(K) PLAN 2021 823640208 2022-03-21 MODERN DERMATOLOGY, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 2036350770
Plan sponsor’s address 1032 POST ROAD EAST, WESTPORT, CT, 06880

Signature of

Role Plan administrator
Date 2022-03-21
Name of individual signing RHONDA KLEIN
Valid signature Filed with authorized/valid electronic signature
MODERN DERMATOLOGY 401(K) PLAN 2020 823640208 2021-02-04 MODERN DERMATOLOGY, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 2036350770
Plan sponsor’s address 1032 POST ROAD EAST, WESTPORT, CT, 06880

Signature of

Role Plan administrator
Date 2021-02-04
Name of individual signing RHONDA KLEIN
Valid signature Filed with authorized/valid electronic signature
MODERN DERMATOLOGY 401(K) PLAN 2019 823640208 2020-03-09 MODERN DERMATOLOGY, P.C. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621111
Sponsor’s telephone number 2036350770
Plan sponsor’s address 1032 POST ROAD EAST, WESTPORT, CT, 06880

Signature of

Role Plan administrator
Date 2020-03-09
Name of individual signing RHONDA KLEIN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
PARRETT, PORTO, PARESE & COLWELL, PROFESSIONAL CORPORATION Agent

Officer

Name Role Business address Residence address
RHONDA Q. KLEIN M.D. Officer 1032 POST ROAD EAST, WESTPORT, CT, 06880, United States 12 WOODCOCK LANE, WESTPORT, CT, 06880, United States
DEANNE M. ROBINSON M.D. Officer 1032 POST ROAD EAST, WESTPORT, CT, 06880, United States 63 Rockwell Rd, Ridgefield, CT, 06877-5007, United States

Director

Name Role Business address Residence address
RHONDA Q. KLEIN M.D. Director 1032 POST ROAD EAST, WESTPORT, CT, 06880, United States 12 WOODCOCK LANE, WESTPORT, CT, 06880, United States
DEANNE M. ROBINSON M.D. Director 1032 POST ROAD EAST, WESTPORT, CT, 06880, United States 63 Rockwell Rd, Ridgefield, CT, 06877-5007, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012119850 2024-03-14 No data Annual Report Annual Report No data
BF-0011344071 2023-03-20 No data Annual Report Annual Report No data
BF-0010353389 2022-03-14 No data Annual Report Annual Report 2022
0007331540 2021-05-11 No data Annual Report Annual Report 2021
0006881783 2020-04-13 No data Change of Business Address Business Address Change No data
0006881778 2020-04-13 2020-04-13 First Report Organization and First Report No data
0005966207 2017-11-14 2017-11-14 Business Formation Certificate of Incorporation No data

Date of last update: 11 Nov 2024

Sources: Connecticut's Official State Website