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NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C.

Company Details

Entity Name: NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Dissolved
Date Formed: 02 Sep 1975
Date of dissolution: 27 Apr 2021
Business ALEI: 0033756
Annual report due: 28 Sep 2020
NAICS code: 621999 - All Other Miscellaneous Ambulatory Health Care Services
Business address: 100 RETREAT AVE, HARTFORD, CT, 06106, United States
Mailing address: 100 RETREAT AVE, HARTFORD, CT, United States, 06106
ZIP code: 06106
County: Hartford
Place of Formation: CONNECTICUT
Total authorized shares: 5000
E-Mail: korrie.beaulieu@hhchealth.org

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. 2018 060931660 2019-12-03 NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-09-02
Business code 621111
Sponsor’s telephone number 8602780070
Plan sponsor’s address 100 RETREAT AVENUE, STE 705, HARTFORD, CT, 061062553

Signature of

Role Plan administrator
Date 2019-12-03
Name of individual signing DAVID KVAM, M.D.
Valid signature Filed with authorized/valid electronic signature
NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. PROFIT SHARING PLAN 2018 060931660 2019-07-08 NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-09-02
Business code 621111
Sponsor’s telephone number 8602780070
Plan sponsor’s address 100 RETREAT AVENUE, STE 705, HARTFORD, CT, 061062553

Signature of

Role Plan administrator
Date 2019-07-08
Name of individual signing DAVID KVAM, M.D.
Valid signature Filed with authorized/valid electronic signature
NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. PROFIT SHARING PLAN 2017 060931660 2018-09-06 NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-09-02
Business code 621111
Sponsor’s telephone number 8602780070
Plan sponsor’s address 100 RETREAT AVENUE, STE 705, HARTFORD, CT, 061062553

Signature of

Role Plan administrator
Date 2018-09-06
Name of individual signing DAVID KVAM, M.D.
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-09-06
Name of individual signing DAVID A. KVAM, M.D.
Valid signature Filed with authorized/valid electronic signature
NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. PROFIT SHARING PLAN 2016 060931660 2017-06-16 NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-09-02
Business code 621111
Sponsor’s telephone number 8602780070
Plan sponsor’s address 100 RETREAT AVENUE, STE 705, HARTFORD, CT, 061062553

Signature of

Role Plan administrator
Date 2017-06-16
Name of individual signing DAVID KVAM, M.D.
Valid signature Filed with authorized/valid electronic signature
NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. PROFIT SHARING PLAN 2015 060931660 2016-04-13 NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-09-02
Business code 621111
Sponsor’s telephone number 8602780070
Plan sponsor’s address 100 RETREAT AVENUE, STE 705, HARTFORD, CT, 061062553

Signature of

Role Plan administrator
Date 2016-04-13
Name of individual signing DAVID KVAM, M.D.
Valid signature Filed with authorized/valid electronic signature
NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. PROFIT SHARING PLAN 2014 060931660 2015-09-25 NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-09-02
Business code 621111
Sponsor’s telephone number 8602780070
Plan sponsor’s address 100 RETREAT AVENUE, STE 705, HARTFORD, CT, 061062553

Signature of

Role Plan administrator
Date 2015-09-25
Name of individual signing DAVID KVAM, M.D.
Valid signature Filed with authorized/valid electronic signature
NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. PROFIT SHARING PLAN 2013 060931660 2014-10-13 NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-09-02
Business code 621111
Sponsor’s telephone number 8602780070
Plan sponsor’s address 100 RETREAT AVENUE, STE 705, HARTFORD, CT, 061062553

Signature of

Role Plan administrator
Date 2014-10-13
Name of individual signing DAVID KVAM, M.D.
Valid signature Filed with authorized/valid electronic signature
NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. PROFIT SHARING PLAN 2012 060931660 2013-10-02 NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-09-02
Business code 621111
Sponsor’s telephone number 8602780070
Plan sponsor’s address 100 RETREAT AVENUE, STE 705, HARTFORD, CT, 061062553

Signature of

Role Plan administrator
Date 2013-10-02
Name of individual signing DAVID KVAM, M.D.
Valid signature Filed with authorized/valid electronic signature
NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. PROFIT SHARING PLAN 2011 060931660 2012-10-11 NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-09-02
Business code 621111
Sponsor’s telephone number 8602780070
Plan sponsor’s address 100 RETREAT AVENUE, STE 705, HARTFORD, CT, 061062553

Plan administrator’s name and address

Administrator’s EIN 060931660
Plan administrator’s name NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C.
Plan administrator’s address 100 RETREAT AVENUE, STE 705, HARTFORD, CT, 061062553
Administrator’s telephone number 8602780070

Signature of

Role Plan administrator
Date 2012-10-11
Name of individual signing DAVID KVAM, M.D.
Valid signature Filed with authorized/valid electronic signature
NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. PROFIT SHARING PLAN 2010 060931660 2011-10-18 NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-09-02
Business code 621111
Sponsor’s telephone number 8602780070
Plan sponsor’s address 100 RETREAT AVENUE, STE 705, HARTFORD, CT, 061062553

Plan administrator’s name and address

Administrator’s EIN 060931660
Plan administrator’s name NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C.
Plan administrator’s address 100 RETREAT AVENUE, STE 705, HARTFORD, CT, 061062553
Administrator’s telephone number 8602780070

Signature of

Role Plan administrator
Date 2011-10-18
Name of individual signing DAVID KVAM, M.D.
Valid signature Filed with authorized/valid electronic signature

Officer

Name Role Business address Residence address
DAVID A. KVAM Officer 100 RETREAT AVE, HARTFORD, CT, 06106, United States 11 COLONY ROAD, WEST HARTFORD, CT, 06117, United States
ARNOLD J. ROSSI Officer 100 RETREAT AVE, HARTFORD, CT, 06106, United States 23 WINTERGREEN LANE, WEST HARTFORD, CT, 06117, United States

Agent

Name Role Business address Mailing address E-Mail Residence address
NORMAN H GAHM Agent 100 RETREAT AVE, HARTFORD, CT, 06106, United States 100 RETREAT AVE, HARTFORD, CT, 06106, United States korrie.beaulieu@hhchealth.org 103 BROOKHAVEN RD, GLASTONBURY, CT, 06033, United States

History

Type Old value New value Date of change
Name change NORMAN H. GAHM, M.D., P.C. NEUROSURGEONS OF CENTRAL CONNECTICUT, P.C. 1982-10-20

Filing

Filing number Filing date Effective date Filing category Filing type Report year
0007309581 2021-04-27 2021-04-27 Dissolution Certificate of Dissolution No data
0006877558 2020-04-07 No data Annual Report Annual Report 2019
0006877556 2020-04-07 No data Annual Report Annual Report 2018
0006237321 2018-08-24 No data Annual Report Annual Report 2016
0006237323 2018-08-24 No data Annual Report Annual Report 2017
0005475276 2016-01-28 No data Annual Report Annual Report 2014
0005475273 2016-01-28 No data Annual Report Annual Report 2013
0005475280 2016-01-28 No data Annual Report Annual Report 2015
0004823501 2013-03-18 No data Annual Report Annual Report 2012
0004823498 2013-03-18 No data Annual Report Annual Report 2010

Date of last update: 06 Jan 2025

Sources: Connecticut's Official State Website