| Entity Name: | Connecticut Independent Physician Practice Association, Inc. |
| Jurisdiction: | Connecticut |
| Legal type: | Non-Stock |
| Citizenship: | Domestic |
| Status: | Active |
| Sub status: | Annual report due |
| Date Formed: | 05 Mar 2024 |
| Business ALEI: | 2961916 |
| Annual report due: | 04 Jun 2025 |
| NAICS code: | 561990 - All Other Support Services |
| Business address: | 65 Seymour Street, Suite 1000, Hartford, CT, 06106, United States |
| Mailing address: | 65 Seymour Street, Suite 1000, Hartford, CT, United States, 06106 |
| ZIP code: | 06106 |
| County: | Hartford |
| Place of Formation: | CONNECTICUT |
| E-Mail: | eileen.downes@katten.com |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| David Hergan, M.D. | Officer | 430 Saybrook Rd, Middletown, CT, 06457-4747, United States | 430 Saybrook Rd, Middletown, CT, 06457-4747, United States |
| Matthew Saidel, M.D. | Officer | 80 Seymour St, Hartford, CT, 06106-2701, United States | 80 Seymour St, Hartford, CT, 06106-2701, United States |
| Jeffry Nestler, M.D. | Officer | 65 Seymour Street, Suite 1000, Hartford, CT, 06106, United States | 65 Seymour Street, Suite 1000, Hartford, CT, 06106, United States |
| Mark Camel, M.D. | Officer | 6 Greenwich Office Park, Greenwich, CT, 06831-5115, United States | 6 Greenwich Office Park, Greenwich, CT, 06831-5115, United States |
| Patrick Seiler | Officer | 65 Seymour Street, Suite 1000, Hartford, CT, 06106, United States | 65 Seymour Street, Suite 1000, Hartford, CT, 06106, United States |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| David Hergan, M.D. | Director | 430 Saybrook Rd, Middletown, CT, 06457-4747, United States | 430 Saybrook Rd, Middletown, CT, 06457-4747, United States |
| Matthew Saidel, M.D. | Director | 80 Seymour St, Hartford, CT, 06106-2701, United States | 80 Seymour St, Hartford, CT, 06106-2701, United States |
| Jeffry Nestler, M.D. | Director | 65 Seymour Street, Suite 1000, Hartford, CT, 06106, United States | 65 Seymour Street, Suite 1000, Hartford, CT, 06106, United States |
| Mark DeFrancesco, M.D. | Director | 60 Westwood Ave Ste 200, Waterbury, CT, 06708-2460, United States | 60 Westwood Ave Ste 200, Waterbury, CT, 06708-2460, United States |
| Mark Camel, M.D. | Director | 6 Greenwich Office Park, Greenwich, CT, 06831-5115, United States | 6 Greenwich Office Park, Greenwich, CT, 06831-5115, United States |
| Joseph Cappa, M.D. | Director | 300 Western Blvd, Glastonbury, CT, 06033, United States | 300 Western Blvd, Glastonbury, CT, 06033, United States |
| Pouyan Changizzadeh, M.D. | Director | 330 Washington St Ste 220, Norwich, CT, 06360-2700, United States | 330 Washington St Ste 220, Norwich, CT, 06360-2700, United States |
| Dinesh Kapur, M.D. | Director | 330 Washington St Ste 220, Norwich, CT, 06360-2700, United States | 330 Washington St Ste 220, Norwich, CT, 06360-2700, United States |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0013272085 | 2024-12-02 | No data | Mass Agent Change � Address | Agent Address Change | No data |
| BF-0012576560 | 2024-06-04 | 2024-06-04 | First Report | Organization and First Report | No data |
| BF-0012575897 | 2024-03-05 | No data | Business Formation | Certificate of Incorporation | No data |
Date of last update: 13 Jan 2025
Sources: Connecticut's Official State Website
