| Name: | KAPLAN & OLCHOWSKI MEDICAL ASSOCIATES, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 31 Aug 1981 (43 years ago) |
| Date of Dissolution: | 01 Dec 2015 (9 years ago) |
| Date of Status Change: | 01 Dec 2015 (9 years ago) |
| Identification Number: | 000014497 |
| ZIP code: | 02904 |
| County: | Providence County |
| Principal Address: | 827 NORTH MAIN STREET, PROVIDENCE, RI, 02904, USA |
| Purpose: | GENERAL PRACTICE OF MEDICINE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538387048 | 2007-04-22 | 2020-08-22 | 827 N MAIN ST, PROVIDENCE, RI, 029045751, US | 827 N MAIN ST, PROVIDENCE, RI, 029045751, US | |||||||||||||||||||||||||
|
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| Phone | +1 401-273-6830 |
| Fax | 4012735925 |
Authorized person
| Name | DR. EDWARD CARL OLCHOWSKI |
| Role | PART OWNER |
| Phone | 4012736830 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | 05428 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RI BLUE CROSS |
| Number | 1102-4 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| CARL I. FREEDMAN, ESQ. | Agent | ONE PARK ROW SUITE 300, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| SHELDON D KAPLAN | TREASURER | 827 NORTH MAIN STREET PROVIDENCE, RI 02904 USA |
| Name | Role | Address |
|---|---|---|
| SHELDON D KAPLAN | SECRETARY | 827 NORTH MAIN STREET PROVIDENCE, RI 02904 USA |
| Name | Role | Address |
|---|---|---|
| SHELDON D KAPLAN | PRESIDENT | 827 NORTH MAIN STREET PROVIDENCE, RI 02904 USA |
| Number | Name | File Date |
|---|---|---|
| 201588583570 | Revocation Certificate For Failure to File the Annual Report for the Year | 2015-12-01 |
| 201564630210 | Revocation Notice For Failure to File An Annual Report | 2015-07-09 |
| 201435325890 | Annual Report | 2014-02-10 |
| 201310568550 | Annual Report | 2013-01-30 |
| 201288064450 | Annual Report | 2012-01-17 |
| 201174059760 | Annual Report | 2011-01-26 |
| 201057451360 | Annual Report | 2010-01-27 |
| 200940794560 | Annual Report | 2009-01-23 |
| 200807321410 | Annual Report | 2008-02-27 |
Date of last update: 06 Oct 2024
Sources: Rhode Island Department of State
