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  5. BRIDGEPORT FAMILY MEDICINE LLC

BRIDGEPORT FAMILY MEDICINE LLC

Company Details

Entity Name: BRIDGEPORT FAMILY MEDICINE LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 18 Jun 2015
Business ALEI: 1179038
Annual report due: 31 Mar 2026
NAICS code: 621111 - Offices of Physicians (except Mental Health Specialists)
Business address: 112 SUNNYRIDGE AVENUE, FAIRFIELD, CT, 06824, United States
Mailing address: 112 SUNNYRIDGE AVENUE, FAIRFIELD, CT, United States, 06824
ZIP code: 06824
County: Fairfield
Place of Formation: CONNECTICUT
E-Mail: usmedicalextern@gmail.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BFM 401(K) PLAN 2023 474274150 2024-10-14 BRIDGEPORT FAMILY MEDICINE, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2039232204
Plan sponsor’s address 754 CLINTON AVENUE, BRIDGEPORT, CT, 06604

Signature of
Role Plan administrator
Date 2024-10-14
Name of individual signing AWAIS MALIK
Valid signature Filed with authorized/valid electronic signature
BFM 401(K) PLAN 2022 474274150 2023-10-12 BRIDGEPORT FAMILY MEDICINE, LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2039232204
Plan sponsor’s address 754 CLINTON AVENUE, BRIDGEPORT, CT, 06604

Signature of
Role Plan administrator
Date 2023-10-12
Name of individual signing AWAIS MALIK
Valid signature Filed with authorized/valid electronic signature
BFM 401(K) PLAN 2021 474274150 2022-10-14 BRIDGEPORT FAMILY MEDICINE, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2039232204
Plan sponsor’s address 754 CLINTON AVENUE, BRIDGEPORT, CT, 06604

Signature of
Role Plan administrator
Date 2022-10-14
Name of individual signing AWAIS MALIK
Valid signature Filed with authorized/valid electronic signature
BFM 401(K) PLAN 2020 474274150 2021-10-15 BRIDGEPORT FAMILY MEDICINE, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2039232204
Plan sponsor’s address 754 CLINTON AVENUE, BRIDGEPORT, CT, 06604

Signature of
Role Plan administrator
Date 2021-10-15
Name of individual signing AWAIS MALIK
Valid signature Filed with authorized/valid electronic signature
BFM 401(K) PLAN 2019 474274150 2020-08-21 BRIDGEPORT FAMILY MEDICINE, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2039232204
Plan sponsor’s address 754 CLINTON AVENUE, BRIDGEPORT, CT, 06604

Signature of
Role Plan administrator
Date 2020-08-21
Name of individual signing AWAIS MALIK
Valid signature Filed with authorized/valid electronic signature
BFM 401(K) RETIREMENT PLAN 2018 474274150 2019-07-28 BRIDGEPORT FAMILY MEDICINE LLC 1
Three-digit plan number (PN) 001
Effective date of plan 2017-12-31
Business code 621111
Sponsor’s telephone number 2032436018
Plan sponsor’s DBA name BRIDGEPORT FAMILY MEDICINE LLC
Plan sponsor’s address 754 CLINTON AVE, BRIDGEPORT, CT, 066042301

Signature of
Role Employer/plan sponsor
Date 2019-07-28
Name of individual signing AWAIS MALIK
Valid signature Filed with authorized/valid electronic signature
BFM 401(K) RETIREMENT PLAN 2018 474274150 2019-09-27 BRIDGEPORT FAMILY MEDICINE LLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-12-31
Business code 621111
Sponsor’s telephone number 2032436018
Plan sponsor’s DBA name BRIDGEPORT FAMILY MEDICINE LLC
Plan sponsor’s address 754 CLINTON AVE, BRIDGEPORT, CT, 066042301

Signature of
Role Plan administrator
Date 2019-09-27
Name of individual signing AHMED EBRAHIM
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-27
Name of individual signing AHMED EBRAHIM
Valid signature Filed with authorized/valid electronic signature
BFM 401(K) PLAN 2018 474274150 2020-02-21 BRIDGEPORT FAMILY MEDICINE, LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2039232204
Plan sponsor’s address 754 CLINTON AVENUE, BRIDGEPORT, CT, 06604

Signature of
Role Plan administrator
Date 2020-02-21
Name of individual signing AWAIS MALIK
Valid signature Filed with authorized/valid electronic signature
BFM 401(K) PLAN 2017 474274150 2020-02-21 BRIDGEPORT FAMILY MEDICINE, LLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2039232204
Plan sponsor’s address 754 CLINTON AVENUE, BRIDGEPORT, CT, 06604

Signature of
Role Plan administrator
Date 2020-02-21
Name of individual signing AWAIS MALIK
Valid signature Filed with authorized/valid electronic signature
BFM 401(K) RETIREMENT PLAN 2017 474274150 2019-06-17 BRIDGEPORT FAMILY MEDICINE LLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-12-31
Business code 621111
Sponsor’s telephone number 2032436018
Plan sponsor’s address 754 CLINTON AVE, BRIDGEPORT, CT, 066042301

Signature of
Role Plan administrator
Date 2019-06-17
Name of individual signing AWAIS MALIK
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-06-17
Name of individual signing AWAIS MALIK
Valid signature Filed with authorized/valid electronic signature

Officer

Name Role Business address Phone E-Mail Residence address
AWAIS MALIK Officer 112 SUNNYRIDGE AVENUE, FAIRFIELD, CT, 06824, United States +1 203-243-6018 SONICS110@YAHOO.COM 754 Clinton Ave, Bridgeport, CT, 06604-2369, United States

Agent

Name Role Business address Mailing address Phone E-Mail Residence address
AWAIS MALIK Agent 112 SUNNYRIDGE AVE, FAIRFIELD, CT, 06824, United States 112 SUNNYRIDGE AVE, FAIRFIELD, CT, 06824, United States +1 203-243-6018 SONICS110@YAHOO.COM 754 Clinton Ave, Bridgeport, CT, 06604-2369, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012416319 2024-01-26 No data Annual Report Annual Report No data
BF-0011213193 2023-01-14 No data Annual Report Annual Report No data
BF-0010649281 2022-06-24 No data Annual Report Annual Report No data
BF-0009833377 2022-06-14 No data Annual Report Annual Report No data
BF-0009123215 2022-06-14 No data Annual Report Annual Report 2020
0006457822 2019-03-13 No data Annual Report Annual Report 2019
0006377445 2019-02-11 No data Annual Report Annual Report 2018
0006377439 2019-02-11 No data Annual Report Annual Report 2017
0005858625 2017-06-06 No data Annual Report Annual Report 2016
0005353490 2015-06-18 2015-06-18 Business Formation Certificate of Organization No data

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
8791498304 2021-01-30 0156 PPS 754 Clinton Ave, Bridgeport, CT, 06604-2369
Loan Status Date 2021-11-19
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 119125
Loan Approval Amount (current) 119125
Undisbursed Amount 0
Franchise Name -
Lender Location ID 48270
Servicing Lender Name JPMorgan Chase Bank, National Association
Servicing Lender Address 1111 Polaris Pkwy, COLUMBUS, OH, 43240-2031
Rural or Urban Indicator U
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address Bridgeport, FAIRFIELD, CT, 06604-2369
Project Congressional District CT-04
Number of Employees 12
NAICS code 621111
Borrower Race Asian
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 48270
Originating Lender Name JPMorgan Chase Bank, National Association
Originating Lender Address COLUMBUS, OH
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 119896.8
Forgiveness Paid Date 2021-09-29
2825447709 2020-05-01 0156 PPP 754 CLINTON AVE, BRIDGEPORT, CT, 06604
Loan Status Date 2021-03-20
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 87777
Loan Approval Amount (current) 87777
Undisbursed Amount 0
Franchise Name -
Lender Location ID 48270
Servicing Lender Name JPMorgan Chase Bank, National Association
Servicing Lender Address 1111 Polaris Pkwy, COLUMBUS, OH, 43240-2031
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address BRIDGEPORT, FAIRFIELD, CT, 06604-1000
Project Congressional District CT-04
Number of Employees 8
NAICS code 621999
Borrower Race Asian
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 194093
Originating Lender Name JPMorgan Chase Bank, National Association
Originating Lender Address CHICAGO, IL
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 88350.3
Forgiveness Paid Date 2021-02-12

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Date of last update: 10 Mar 2025

Sources: Connecticut's Official State Website

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