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  5. Cheshire Dermatology, PLLC

Cheshire Dermatology, PLLC

Company Details

Entity Name: Cheshire Dermatology, PLLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 16 Dec 1997
Business ALEI: 0578454
Annual report due: 31 Mar 2025
NAICS code: 621111 - Offices of Physicians (except Mental Health Specialists)
Business address: 677 SOUTH MAIN ST, CHESHIRE, CT, 06410, United States
Mailing address: 677 SOUTH MAIN ST, CHESHIRE, CT, United States, 06410
ZIP code: 06410
County: New Haven
Place of Formation: CONNECTICUT
E-Mail: dana.correale.md@gmail.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PAULA M. BEVILACQUA, MD, LLC 401(K) PROFIT SHARING PLAN AND TRUST 2023 300622059 2024-10-07 PAULA M. BEVILACQUA, MD, LLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2032507577
Plan sponsor’s address 677 SOUTH MAIN ST., CHESHIRE, CT, 06410

Signature of
Role Plan administrator
Date 2024-10-07
Name of individual signing PAULA BEVILACQUA
Valid signature Filed with authorized/valid electronic signature
PAULA M. BEVILACQUA, MD, LLC 401(K) PROFIT SHARING PLAN 2022 300622059 2023-05-30 PAULA M BEVILACQUA, MD LLC 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2032507577
Plan sponsor’s address 677 SOUTH MAIN STREET, CHESHIRE, CT, 06410

Signature of
Role Plan administrator
Date 2023-05-30
Name of individual signing PAULA BEVILACQUA
Valid signature Filed with authorized/valid electronic signature
PAULA M. BEVILACQUA, MD, LLC 401(K) PROFIT SHARING PLAN 2021 300622059 2022-07-07 PAULA M BEVILACQUA, MD LLC 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2032507577
Plan sponsor’s address 677 SOUTH MAIN STREET, CHESHIRE, CT, 06410

Signature of
Role Plan administrator
Date 2022-07-07
Name of individual signing PAULA BEVILACQUA
Valid signature Filed with authorized/valid electronic signature
PAULA M. BEVILACQUA, MD, LLC 401(K) PROFIT SHARING PLAN 2020 300622059 2021-10-04 PAULA M BEVILACQUA, MD LLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2032507577
Plan sponsor’s address 677 SOUTH MAIN STREET, CHESHIRE, CT, 06410

Signature of
Role Plan administrator
Date 2021-10-04
Name of individual signing PAULA BEVILACQUA
Valid signature Filed with authorized/valid electronic signature
PAULA M. BEVILACQUA, MD, LLC 401(K) PROFIT SHARING PLAN 2019 300622059 2020-07-13 PAULA M BEVILACQUA, MD LLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2032507577
Plan sponsor’s address 677 SOUTH MAIN STREET, CHESHIRE, CT, 06410

Plan administrator’s name and address
Administrator’s EIN 300622059
Plan administrator’s name PAULA M BEVILACQUA, MD LLC
Plan administrator’s address 677 SOUTH MAIN STREET, CHESHIRE, CT, 06410
Administrator’s telephone number 2032507577

Signature of
Role Plan administrator
Date 2020-07-13
Name of individual signing PAULA BEVILACQUA
Valid signature Filed with authorized/valid electronic signature
PAULA M. BEVILACQUA, MD, LLC 401(K) PROFIT SHARING PLAN 2018 300622059 2019-07-07 PAULA M BEVILACQUA, MD LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2032507577
Plan sponsor’s address 677 SOUTH MAIN STREET, CHESHIRE, CT, 06410

Plan administrator’s name and address
Administrator’s EIN 300622059
Plan administrator’s name PAULA M BEVILACQUA, MD LLC
Plan administrator’s address 677 SOUTH MAIN STREET, CHESHIRE, CT, 06410
Administrator’s telephone number 2032507577

Signature of
Role Plan administrator
Date 2019-07-07
Name of individual signing PAULA BEVILACQUA
Valid signature Filed with authorized/valid electronic signature
PAULA M. BEVILACQUA, MD, LLC 401(K) PROFIT SHARING PLAN 2017 300622059 2018-09-26 PAULA M BEVILACQUA, MD LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2032507577
Plan sponsor’s address 677 SOUTH MAIN STREET, CHESHIRE, CT, 06410

Plan administrator’s name and address
Administrator’s EIN 300622059
Plan administrator’s name PAULA M BEVILACQUA, MD LLC
Plan administrator’s address 677 SOUTH MAIN STREET, CHESHIRE, CT, 06410
Administrator’s telephone number 2032507577

Signature of
Role Plan administrator
Date 2018-09-26
Name of individual signing PAULA BEVILACQUA
Valid signature Filed with authorized/valid electronic signature
PAULA M. BEVILACQUA, MD, LLC 401(K) PROFIT SHARING PLAN 2016 300622059 2017-07-13 PAULA M BEVILACQUA, MD LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2032507577
Plan sponsor’s address 677 SOUTH MAIN STREET, CHESHIRE, CT, 06410

Plan administrator’s name and address
Administrator’s EIN 300622059
Plan administrator’s name PAULA M BEVILACQUA, MD LLC
Plan administrator’s address 677 SOUTH MAIN STREET, CHESHIRE, CT, 06410
Administrator’s telephone number 2032507577

Signature of
Role Plan administrator
Date 2017-07-13
Name of individual signing PAULA BEVILACQUA
Valid signature Filed with authorized/valid electronic signature
PAULA M. BEVILACQUA, MD, LLC 401(K) PROFIT SHARING PLAN 2015 300622059 2016-05-28 PAULA M BEVILACQUA, MD LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2032507577
Plan sponsor’s address 41 BROOKSIDE DRIVE, HAMDEN, CT, 06517

Plan administrator’s name and address
Administrator’s EIN 300622059
Plan administrator’s name PAULA M BEVILACQUA, MD LLC
Plan administrator’s address 41 BROOKSIDE DRIVE, HAMDEN, CT, 06517
Administrator’s telephone number 2032507577

Signature of
Role Plan administrator
Date 2016-05-28
Name of individual signing PAULA BEVILACQUA
Valid signature Filed with authorized/valid electronic signature
PAULA M. BEVILACQUA, MD, LLC 401(K) PROFIT SHARING PLAN 2014 300622059 2015-07-05 PAULA M BEVILACQUA, MD LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2032507577
Plan sponsor’s address 41 BROOKSIDE DRIVE, HAMDEN, CT, 06517

Plan administrator’s name and address
Administrator’s EIN 300622059
Plan administrator’s name PAULA M BEVILACQUA, MD LLC
Plan administrator’s address 41 BROOKSIDE DRIVE, HAMDEN, CT, 06517
Administrator’s telephone number 2032507577

Signature of
Role Plan administrator
Date 2015-07-05
Name of individual signing PAULA BEVILACQUA
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Mailing address Phone E-Mail Residence address
Dana Correale Agent 677 SOUTH MAIN ST, CHESHIRE, CT, 06410, United States 677 SOUTH MAIN ST, CHESHIRE, CT, 06410, United States +1 203-393-8881 dana.correale.md@gmail.com 280 Amity Rd, Bethany, CT, 06524-3430, United States

Officer

Name Role Business address Phone E-Mail Residence address
Dana Correale Officer 677 SOUTH MAIN ST, CHESHIRE, CT, 06410, United States +1 203-393-8881 dana.correale.md@gmail.com 280 Amity Rd, Bethany, CT, 06524-3430, United States

History

Type Old value New value Date of change
Name change PAULA M. BEVILACQUA, MD, LLC Cheshire Dermatology, PLLC 2024-01-01

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012157763 2024-01-17 No data Annual Report Annual Report No data
BF-0012509295 2023-12-28 2024-01-01 Name Change Amendment Certificate of Amendment No data
BF-0009773124 2023-09-17 No data Annual Report Annual Report No data
BF-0010791934 2023-09-17 No data Annual Report Annual Report No data
BF-0011263885 2023-09-17 No data Annual Report Annual Report No data
BF-0011947568 2023-08-28 No data Administrative Dissolution Notice of Intent to Dissolve/Revoke No data
0006825585 2020-03-10 No data Annual Report Annual Report 2015
0006825588 2020-03-10 No data Annual Report Annual Report 2017
0006825584 2020-03-10 No data Annual Report Annual Report 2014
0006825591 2020-03-10 No data Annual Report Annual Report 2020

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 20 Jan 2025

Sources: Connecticut's Official State Website

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