| Entity Name: | HER TRANSFORMATION OBGYN, PLLC |
| Jurisdiction: | Connecticut |
| Legal type: | LLC |
| Citizenship: | Domestic |
| Status: | Active |
| Sub status: | Annual report due |
| Date Formed: | 20 Feb 2018 |
| Business ALEI: | 1264341 |
| Annual report due: | 31 Mar 2025 |
| NAICS code: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| Business address: | 2228 BLACK ROCK TURNPIKE SUITE 211, FAIRFIELD, CT, 06825, United States |
| Mailing address: | 2228 BLACK ROCK TURNPIKE SUITE 211, FAIRFIELD, CT, United States, 06825 |
| ZIP code: | 06825 |
| County: | Fairfield |
| Place of Formation: | CONNECTICUT |
| E-Mail: | vedusa@htobgyn.com |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HER TRANSFORMATION 401(K) PROFIT SHARING PLAN | 2023 | 824567381 | 2024-10-04 | HER TRANSFORMATION OBGYN, PLLC | 2 | |||||||||||||||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2024-10-04 |
| Name of individual signing | VALENTINE EDUSA |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2024-10-04 |
| Name of individual signing | VALENTINE EDUSA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2021-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2036451744 |
| Plan sponsor’s address | 2228 BLACK ROCK TURNPIKE, SUITE 211, FAIRFIELD, CT, 06825 |
Signature of
| Role | Plan administrator |
| Date | 2024-10-04 |
| Name of individual signing | VALENTINE EDUSA |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2024-10-04 |
| Name of individual signing | VALENTINE EDUSA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2021-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2036451744 |
| Plan sponsor’s address | 2228 BLACK ROCK TURNPIKE, SUITE 211, FAIRFIELD, CT, 06825 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-13 |
| Name of individual signing | VALENTINE EDUSA |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2023-10-13 |
| Name of individual signing | VALENTINE EDUSA |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2021-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2036451744 |
| Plan sponsor’s address | 2228 BLACK ROCK TURNPIKE, SUITE 211, FAIRFIELD, CT, 06825 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-13 |
| Name of individual signing | VALENTINE EDUSA |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2023-10-13 |
| Name of individual signing | VALENTINE EDUSA |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| CN SEARCH L.L.C. | Agent |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| VALENTINE EDUSA MD, FACOG | Officer | 2228 BLACK ROCK TURNPIKE, SUITE 211, FAIRFIELD, CT, 06825, United States | 409 Sea Hill Rd, North Branford, CT, 06471-1413, United States |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0012196670 | 2024-02-29 | No data | Annual Report | Annual Report | No data |
| BF-0011354571 | 2023-02-25 | No data | Annual Report | Annual Report | No data |
| BF-0010396473 | 2022-02-16 | No data | Annual Report | Annual Report | 2022 |
| 0007104085 | 2021-02-02 | No data | Annual Report | Annual Report | 2021 |
| 0006846382 | 2020-03-24 | No data | Annual Report | Annual Report | 2020 |
| 0006595743 | 2019-07-03 | 2019-07-03 | Change of Agent Address | Agent Address Change | No data |
| 0006421777 | 2019-03-04 | No data | Annual Report | Annual Report | 2019 |
| 0006262830 | 2018-10-23 | 2018-10-23 | Change of Business Address | Business Address Change | No data |
| 0006133949 | 2018-02-26 | 2018-02-26 | Change of Email Address | Business Email Address Change | No data |
| 0006095034 | 2018-02-20 | 2018-02-20 | Business Formation | Certificate of Organization | No data |
Date of last update: 06 Jan 2025
Sources: Connecticut's Official State Website
