| Name: | Diabetes & Endocrinology Associates, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 30 Apr 1975 (50 years ago) |
| Identification Number: | 000007144 |
| ZIP code: | 02906 |
| County: | Providence County |
| Principal Address: | 100 HIGHLAND AVE SUITE 203, PROVIDENCE, RI, 02906, US |
| Purpose: | PROVIDE MEDICAL SERVICES BY PHYSICIANS |
NAICS
621111 Offices of Physicians (except Mental Health Specialists)This U.S. industry comprises establishments of health practitioners having the degree of M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy) primarily engaged in the independent practice of general or specialized medicine (except psychiatry or psychoanalysis) or surgery. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407954415 | 2006-09-21 | 2015-01-12 | 100 HIGHLAND AVE, PROVIDENCE, RI, 029062740, US | 100 HIGHLAND AVE, PROVIDENCE, RI, 029062740, US | |||||||||||||||||||
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| Phone | +1 401-351-7100 |
Authorized person
| Name | CHARLES B KAHN |
| Role | PRESIDENT |
| Phone | 4013517100 |
Taxonomy
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 9000831 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| DENNIS S. KRAUSS, MD | Agent | 100 HIGHLAND AVENUE SUITE 203, PROVIDENCE, RI, 02906, USA |
| Name | Role | Address |
|---|---|---|
| ROBERT J DOBRZYNSKI MD | PRESIDENT | 100 HIGHLAND AVE PROVIDENCE, RI 02906 US |
| Name | Role | Address |
|---|---|---|
| AMAYA HODARKAR MD | TREASURER | 100 HIGHLAND AVE PROVIDENCE, RI 02906 US |
| Name | Role | Address |
|---|---|---|
| MANCHIN CHANG | SECRETARY | 100 HIGHLAND AVE PROVIDENCE, RI 02906 USA |
| Name | Role | Address |
|---|---|---|
| ROBERTO ORTIZ | VICE PRESIDENT | 100 HIGHLAND AVE PROVIDENCE, RI 02906 USA |
| Number | Name | File Date |
|---|---|---|
| 202452304790 | Annual Report | 2024-04-24 |
| 202331956320 | Annual Report | 2023-03-29 |
| 202208726160 | Annual Report | 2022-01-27 |
| 202184359440 | Annual Report | 2021-01-05 |
| 202032765870 | Annual Report | 2020-01-22 |
| 201983966950 | Annual Report | 2019-01-08 |
| 201858275110 | Annual Report | 2018-02-14 |
| 201629205450 | Annual Report | 2016-12-29 |
| 201690840910 | Annual Report | 2016-01-19 |
| 201553408840 | Annual Report | 2015-01-13 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2649697202 | 2020-04-16 | 0165 | PPP | 100 Highland Ave 203, Providence, RI, 02906 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 06 Apr 2025
Sources: Rhode Island Department of State
