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EYE SURGERY ASSOCIATES, LLC

Company Details

Entity Name: EYE SURGERY ASSOCIATES, LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Dissolved
Date Formed: 21 Jul 2000
Date of dissolution: 08 Jul 2020
Business ALEI: 0657148
Business address: 3060 MAIN STREET, STRATFORD, CT, 06614
ZIP code: 06614
County: Fairfield
Place of Formation: CONNECTICUT
E-Mail: esa3060@optonline.net

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN 2019 061588474 2020-08-04 EYE SURGERY ASSOCIATES, 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 2033755819
Plan sponsor’s address 495 HAWLEY LANE, STRATFORD, CT, 06614

Signature of

Role Plan administrator
Date 2020-08-04
Name of individual signing BRIAN M DEBROFF
Valid signature Filed with authorized/valid electronic signature
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN 2018 061588474 2019-10-02 EYE SURGERY ASSOCIATES, LLC 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2033755819
Plan sponsor’s address 495 HAWLEY LANE, STRATFORD, CT, 06614

Signature of

Role Plan administrator
Date 2019-10-02
Name of individual signing BRIAN M DEBROFF
Valid signature Filed with authorized/valid electronic signature
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN 2017 061588474 2018-06-01 EYE SURGERY ASSOCIATES, 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 2033755819
Plan sponsor’s address 495 HAWLEY LANE, STRATFORD, CT, 06614

Signature of

Role Plan administrator
Date 2018-06-01
Name of individual signing BRIAN M. DEBROFF
Valid signature Filed with authorized/valid electronic signature
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN 2016 061588474 2017-05-21 EYE SURGERY ASSOCIATES, 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 2033755819
Plan sponsor’s address 495 HAWLEY LANE, STRATFORD, CT, 06614

Signature of

Role Plan administrator
Date 2017-05-21
Name of individual signing BRIAN DEBROFF MD
Valid signature Filed with authorized/valid electronic signature
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN 2015 061588474 2016-06-06 EYE SURGERY ASSOCIATES, 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 2033755819
Plan sponsor’s address 495 HAWLEY LANE, STRATFORD, CT, 06614

Signature of

Role Plan administrator
Date 2016-06-06
Name of individual signing BRIAN M DEBROFF
Valid signature Filed with authorized/valid electronic signature
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN 2014 061588474 2015-06-23 EYE SURGERY ASSOCIATES, LLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2033755819
Plan sponsor’s address 495 HAWLEY LANE, STRATFORD, CT, 06614

Signature of

Role Plan administrator
Date 2015-06-23
Name of individual signing BRIAN DEBROFF
Valid signature Filed with authorized/valid electronic signature
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN 2013 061588474 2014-09-30 EYE SURGERY ASSOCIATES, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2033755819
Plan sponsor’s address 495 HAWLEY LANE, STRATFORD, CT, 06614

Signature of

Role Plan administrator
Date 2014-09-30
Name of individual signing SHIRLEY CORBO
Valid signature Filed with authorized/valid electronic signature
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN 2012 061588474 2013-07-16 EYE SURGERY ASSOCIATES, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2033755819
Plan sponsor’s address 495 HAWLEY LANE, STRATFORD, CT, 06614

Signature of

Role Plan administrator
Date 2013-07-16
Name of individual signing BRIAN M DEBROFF
Valid signature Filed with authorized/valid electronic signature
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN 2011 061588474 2012-06-12 EYE SURGERY ASSOCIATES, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2033755819
Plan sponsor’s address 495 HAWLEY LANE, STRATFORD, CT, 06614

Plan administrator’s name and address

Administrator’s EIN 061588474
Plan administrator’s name EYE SURGERY ASSOCIATES, LLC
Plan administrator’s address 495 HAWLEY LANE, STRATFORD, CT, 06614
Administrator’s telephone number 2033755819

Signature of

Role Plan administrator
Date 2012-06-12
Name of individual signing BRIAN M DEBROFF
Valid signature Filed with authorized/valid electronic signature
EYE SURGERY ASSOCIATES, LLC RETIREMENT PLAN 2010 061588474 2011-06-17 EYE SURGERY ASSOCIATES, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 2033755819
Plan sponsor’s address 3060 MAIN STREET, STRATFORD, CT, 06614

Plan administrator’s name and address

Administrator’s EIN 061588474
Plan administrator’s name EYE SURGERY ASSOCIATES, LLC
Plan administrator’s address 3060 MAIN STREET, STRATFORD, CT, 06614
Administrator’s telephone number 2033755819

Signature of

Role Plan administrator
Date 2011-06-17
Name of individual signing BRIAN M DEBROFF
Valid signature Filed with authorized/valid electronic signature

Officer

Name Role Business address Residence address
BRIAN DEBROFF M.D. Officer 3060 MAIN STREET, STRATFORD, CT, 06614, United States 2220 HUNTINGTON TPK., TRUMBULL, CT, 06611, United States

Agent

Name Role Business address
LEVY & DRONEY, P.C. Agent ATTN: DAVID M. SHERIDAN, 74 BATTERON PARK ROAD, FARMINGTON, CT, 06032, United States

History

Type Old value New value Date of change
Name change ANTHONY MUSTO MD, LLC EYE SURGERY ASSOCIATES, LLC 2000-11-01

Filing

Filing number Filing date Effective date Filing category Filing type Report year
0006944122 2020-07-08 2020-07-08 Dissolution Certificate of Dissolution No data
0004595248 2011-07-13 No data Annual Report Annual Report 2011
0004219494 2010-07-06 No data Annual Report Annual Report 2010
0003990454 2009-07-15 No data Annual Report Annual Report 2009
0003741022 2008-07-14 No data Annual Report Annual Report 2008
0003497102 2007-07-11 No data Annual Report Annual Report 2007
0003266555 2006-07-21 No data Annual Report Annual Report 2006
0003080802 2005-07-27 No data Annual Report Annual Report 2005
0002885773 2004-08-03 No data Annual Report Annual Report 2004
0002677006 2003-07-10 No data Annual Report Annual Report 2003

Date of last update: 06 Jan 2025

Sources: Connecticut's Official State Website