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Aquidneck Medical Associates, Inc.

Company Details

Name: Aquidneck Medical Associates, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Dissolved
Date of Organization in Rhode Island: 01 Jul 1969 (56 years ago)
Date of Dissolution: 31 Mar 2015 (10 years ago)
Date of Status Change: 31 Mar 2015 (10 years ago)
Identification Number: 000001221
ZIP code: 02840
County: Newport County
Purpose: GROUP MEDICAL PRACTICE
Principal Address: Google Maps Logo 50 MEMORIAL BOULEVARD, NEWPORT, RI, 02840, USA

Agent

Name Role Address
JEAN SANDERS Agent 50 MEMORIAL BOULEVARD, NEWPORT, RI, 02840, USA

PRESIDENT

Name Role Address
KEIVAN ETTEFAGH MD PRESIDENT 22 HARVEST STREET PORTSMOUTH, RI 02871 USA

TREASURER

Name Role Address
DAVID S GORELICK MD TREASURER 20 BARK AVE JAMESTOWN, RI 02835 USA

SECRETARY

Name Role Address
CHRISTINA DIEROLF MD SECRETARY 333 CARRIAGE DR PORTSMOUTH, RI 02871 USA

VICE PRESIDENT

Name Role Address
DAVID S GORELICK MD VICE PRESIDENT 20 BARK AVE JAMESTOWN, RI 02835 USA
RALPH T EARP MD VICE PRESIDENT 128 BELMONT DR PORTSMOUTH, RI 02871 USA
JAYANTHI PARAMESWARAN MD VICE PRESIDENT 59 DANIEL CHURCH RD TIVERTON, RI 02878 USA
MARTHA A ULLMAN MD VICE PRESIDENT 9 SAKONNET TER MIDDLETOWN, RI 02842 USA
HAROLD A SANDERS VICE PRESIDENT 75 TAYLOR RD PORTSMOUTH, RI 02871 USA
JENNIFER M SALM MD VICE PRESIDENT 138 ELLERY AVE MIDDLETOWN, RI 02842 USA

National Provider Identifier

NPI Number:
1891831764

Authorized Person:

Name:
PAMELA MARSHALL
Role:
CREDENTIALLING
Phone:

Taxonomy:

Selected Taxonomy:
261QM1300X - Multi-Specialty Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
4018498446

Form 5500 Series

Employer Identification Number (EIN):
050340000
Plan Year:
2013
Number Of Participants:
64
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
62
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
59
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
53
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
51
Sponsors Telephone Number:

Filings

Number Name File Date
201558266670 Articles of Dissolution 2015-03-31
201558137880 Annual Report 2015-03-27
201440300790 Annual Report 2014-06-03
201439361650 Revocation Notice For Failure to File An Annual Report 2014-05-20
201315295910 Statement of Change of Registered/Resident Agent 2013-04-17

Uniform Commercial Code

The Uniform Commercial Code (UCC) is a comprehensive set of laws governing all commercial transactions in the United States.

A UCC filing is a public notice of a secured transaction. A financing statement indicates a commercial agreement between a debtor and a secured party.

Uniform Commercial Code Summary

Type:
UCC-3 TERMINATION
UCC Filing Number:
Filing Date:
2020-12-04
Action:
TerminationSecuredParty

Parties

Party Name:
Aquidneck Medical Associates, Inc.
Party Role:
Debtor(s)

Uniform Commercial Code Summary

Type:
UCC-3 TERMINATION
UCC Filing Number:
Filing Date:
2020-12-04
Action:
TerminationSecuredParty

Parties

Party Name:
Aquidneck Medical Associates, Inc.
Party Role:
Debtor(s)

Uniform Commercial Code Summary

Type:
UCC-3 CONTINUATION
UCC Filing Number:
Filing Date:
2020-11-19
Action:
Continuation

Parties

Party Name:
Aquidneck Medical Associates, Inc.
Party Role:
Debtor(s)
Party Role:
Secured Parties

Date of last update: 16 May 2025

Sources: Rhode Island Department of State