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  5. DEBORAH PAN, M.D., LLC

DEBORAH PAN, M.D., LLC

Company Details

Entity Name: DEBORAH PAN, M.D., LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 03 Jun 2003
Business ALEI: 0749421
Annual report due: 31 Mar 2025
NAICS code: 621111 - Offices of Physicians (except Mental Health Specialists)
Business address: 10 LONG HILL ROAD, GUILFORD, CT, 06437, United States
Mailing address: 10 LONG HILL ROAD, GUILFORD, CT, United States, 06437
ZIP code: 06437
County: New Haven
Place of Formation: CONNECTICUT
E-Mail: deborahpan71@gmail.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DEBORAH PAN, M.D., LLC 401(K) PLAN 2020 571164297 2021-04-03 DEBORAH PAN, M.D., LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2035627662
Plan sponsor’s address 1 AUDUBON STREET, NO 201, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2021-04-03
Name of individual signing DR. DEBORAH PAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-03
Name of individual signing DEBORAH PAN
Valid signature Filed with authorized/valid electronic signature
DEBORAH PAN, M.D., LLC 401(K) PLAN 2019 571164297 2020-07-09 DEBORAH PAN, M.D., LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2035627662
Plan sponsor’s address 1 AUDUBON STREET, NO 201, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2020-07-09
Name of individual signing DR. DEBORAH PAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-09
Name of individual signing DEBORAH PAN
Valid signature Filed with authorized/valid electronic signature
DEBORAH PAN, M.D., LLC 401(K) PLAN 2018 571164297 2019-08-20 DEBORAH PAN, M.D., LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2035627662
Plan sponsor’s address 1 AUDUBON STREET, NO 201, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2019-08-20
Name of individual signing DR. DEBORAH PAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-08-20
Name of individual signing DEBORAH PAN
Valid signature Filed with authorized/valid electronic signature
DEBORAH PAN, M.D., LLC 401(K) PLAN 2017 571164297 2018-10-15 DEBORAH PAN, M.D., LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2035627662
Plan sponsor’s address 1 AUDUBON STREET, NO 201, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing DR. DEBORAH PAN
Valid signature Filed with authorized/valid electronic signature
DEBORAH PAN, M.D., LLC 401(K) PLAN 2016 571164297 2017-04-11 DEBORAH PAN, M.D., LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2035627662
Plan sponsor’s address 1 AUDUBON STREET, NO 201, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2017-04-11
Name of individual signing DR. DEBORAH PAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-04-11
Name of individual signing DEBORAH PAN MD
Valid signature Filed with authorized/valid electronic signature
DEBORAH PAN, M.D., LLC 401(K) PLAN 2015 571164297 2016-06-14 DEBORAH PAN, M.D., LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2035627662
Plan sponsor’s address 1 AUDUBON STREET, NO 201, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2016-06-14
Name of individual signing DR. DEBORAH PAN
Valid signature Filed with authorized/valid electronic signature
DEBORAH PAN, M.D., LLC 401(K) PLAN 2014 571164297 2015-04-22 DEBORAH PAN, M.D., LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2035627662
Plan sponsor’s address 1 AUDUBON STREET, NO 201, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2015-04-22
Name of individual signing DR. DEBORAH PAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-04-22
Name of individual signing DEBORAH PAN, MD
Valid signature Filed with authorized/valid electronic signature
DEBORAH PAN, M.D., LLC 401(K) PLAN 2013 571164297 2014-07-19 DEBORAH PAN, M.D., LLC 7
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2035627662
Plan sponsor’s address 1 AUDUBON STREET, NO 201, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2014-07-19
Name of individual signing DR. DEBORAH PAN
Valid signature Filed with authorized/valid electronic signature
DEBORAH PAN, M.D., LLC 401(K) PLAN 2013 571164297 2014-10-10 DEBORAH PAN, M.D., LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2035627662
Plan sponsor’s address 1 AUDUBON STREET, NO 201, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2014-10-10
Name of individual signing DR. DEBORAH PAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-10
Name of individual signing DEBORAH PAN, MD
Valid signature Filed with authorized/valid electronic signature
DEBORAH PAN, M.D., LLC 401(K) PLAN 2012 571164297 2013-07-02 DEBORAH PAN, M.D., LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2035627662
Plan sponsor’s address 1 AUDUBON STREET, NO 201, NEW HAVEN, CT, 06511

Signature of
Role Plan administrator
Date 2013-07-02
Name of individual signing DR. DEBORAH PAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-07-02
Name of individual signing DEBORAH PAN, MD
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
SATTI PROVATAS MCNAMARA, P.C. Agent

Officer

Name Role Business address Residence address
DEBORAH PAN M.D. Officer 10 Long Hill Rd, Guilford, CT, 06437-1819, United States 19 IRONWOOD ROAD, GUILFORD, CT, 06437, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012213275 2024-03-13 No data Annual Report Annual Report No data
BF-0011272455 2023-01-19 No data Annual Report Annual Report No data
BF-0010411550 2022-03-03 No data Annual Report Annual Report 2022
0007144411 2021-02-10 No data Annual Report Annual Report 2021
0006768056 2020-02-20 No data Annual Report Annual Report 2020
0006436913 2019-03-09 No data Annual Report Annual Report 2019
0006150973 2018-04-02 2018-04-02 Merger Certificate of Merger No data
0006016137 2018-01-18 No data Annual Report Annual Report 2018
0005859823 2017-06-06 No data Annual Report Annual Report 2017
0005800318 2017-03-23 2017-03-23 Amendment Amend No data

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Date of last update: 06 Jan 2025

Sources: Connecticut's Official State Website

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