| Name: | University Otolaryngology - Head and Neck Surgery, Incorporated |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 01 Jul 1969 (56 years ago) |
| Identification Number: | 000010461 |
| ZIP code: | 02818 |
| County: | Kent County |
| Principal Address: | 1351 SOUTH COUNTY TRAIL UNIT 303, EAST GREENWICH, RI, 02818, USA |
| Purpose: | MEDICAL SERVICES |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| Fictitious names: |
New England Otology Center (trading name, 1989-05-10 - ) |
| Historical names: |
PEARSON, MCNELIS & HILL, INC. Pearson, McNelis, Hill & Bellino, Inc. ENT Associates, Inc. |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164730065 | 2010-09-14 | 2012-08-15 | 116 MAIN ST, WAKEFIELD, RI, 028793566, US | 116 MAIN ST, WAKEFIELD, RI, 028793566, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 401-782-4400 |
| Fax | 4017824994 |
Authorized person
| Name | DR. PETER T NIGRI |
| Role | PRESIDENT |
| Phone | 4012722300 |
Taxonomy
| Taxonomy Code | 207YS0123X - Facial Plastic Surgery Physician |
| License Number | 9418 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 9020447 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| BRUCE A. WOLPERT, ESQ. | Agent | 235 PROMENADE STREET SUITE 475, PROVIDENCE, RI, 02908, USA |
| Name | Role | Address |
|---|---|---|
| ANDREW E BURCHARD MD | PRESIDENT | 1351 SOUTH COUNTY TRAIL, UNIT 303 EAST GREENWICH, RI 02818 USA |
| Name | Role | Address |
|---|---|---|
| BRIAN E. DUFF MD | TREASURER | 1351 SOUTH COUNTY TRAIL, UNIT 303 EAST GREENWICH, RI 02818 USA |
| Name | Role | Address |
|---|---|---|
| SHARON E. GIBSON MD | SECRETARY | 1351 SOUTH COUNTY TRAIL, UNIT 303 EAST GREENWICH, RI 02818 USA |
| Name | Role | Address |
|---|---|---|
| JAN C. GROBLEWSKI MD | VICE PRESIDENT | 1351 SOUTH COUNTY TRAIL, UNIT 303 EAST GREENWICH, RI 02818 USA |
| Name | Role | Address |
|---|---|---|
| ANDREW E. BURCHARD MD | DIRECTOR | 1351 SOUTH COUNTY TRAIL, UNIT 303 EAST GREENWICH, RI 02818 USA |
| JAN C. GROBLEWSKI MD | DIRECTOR | 1351 SOUTH COUNTY TRAIL, UNIT 303 EAST GREENWICH, RI 02818 USA |
| BRIAN E. DUFF MD | DIRECTOR | 1351 SOUTH COUNTY TRAIL, UNIT 303 EAST GREENWICH, RI 02818 USA |
| SHARON E. GIBSON MD | DIRECTOR | 1351 SOUTH COUNTY TRAIL, UNIT 303 EAST GREENWICH, RI 02818 USA |
| ROBERT G. MCRAE MD | DIRECTOR | 1351 SOUTH COUNTY TRAIL, UNIT 303 EAST GREENWICH, RI 02818 USA |
| CHARLES M. RUHL MD | DIRECTOR | 1351 SOUTH COUNTY TRAIL, UNIT 303 EAST GREENWICH, RI 02818 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 1996-01-11 | ENT Associates, Inc. | University Otolaryngology - Head and Neck Surgery, Incorporated |
| Name Change | 1974-12-31 | Pearson, McNelis, Hill & Bellino, Inc. | ENT Associates, Inc. |
| Name Change | 1973-04-02 | PEARSON, MCNELIS & HILL, INC. | Pearson, McNelis, Hill & Bellino, Inc. |
| Number | Name | File Date |
|---|---|---|
| 202447482180 | Annual Report | 2024-02-28 |
| 202332061230 | Annual Report | 2023-03-30 |
| 202222507660 | Statement of Change of Registered Office by the Registered Agent | 2022-08-26 |
| 202212377040 | Annual Report | 2022-03-01 |
| 202105028150 | Statement of Change of Registered/Resident Agent | 2021-11-12 |
| 202192797340 | Annual Report | 2021-02-24 |
| 202040304410 | Annual Report | 2020-05-14 |
| 201988612050 | Annual Report | 2019-03-13 |
| 201859157190 | Annual Report | 2018-02-23 |
| 201748089900 | Statement of Change of Registered/Resident Agent | 2017-07-31 |
Date of last update: 05 Oct 2024
Sources: Rhode Island Department of State
