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KLIBANOFF EYE ASSOCIATES, LTD.

Company Details

Name: KLIBANOFF EYE ASSOCIATES, LTD.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 07 Jan 1980 (45 years ago)
Identification Number: 000015660
ZIP code: 02860
County: Providence County
Principal Address: 55 BROAD STREET, PAWTUCKET, RI, 02860, USA
Purpose: PRACTICE OF OPTOMETRY
Historical names: DR. DAVID A. KLIBANOFF and DR. MAX KLIBANOFF, LTD.
PAWTUCKET EYE ASSOCIATES, LTD.

Industry & Business Activity

NAICS

621320 Offices of Optometrists

This industry comprises establishments of health practitioners having the degree of O.D. (Doctor of Optometry) primarily engaged in the independent practice of optometry. These practitioners examine, diagnose, treat, and manage diseases and disorders of the visual system, the eye, and associated structures as well as diagnose related systemic conditions. Offices of optometrists prescribe and/or provide eyeglasses, contact lenses, low vision aids, and vision therapy. They 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, and may also provide the same services as opticians, such as selling and fitting prescription eyeglasses and contact lenses. Learn more at the U.S. Census Bureau

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1528373743 2010-08-12 2010-08-12 121 BROAD ST, PAWTUCKET, RI, 028602053, US 121 BROAD ST, PAWTUCKET, RI, 028602053, US

Contacts

Phone +1 401-723-3400

Authorized person

Name DR. DAVID KLIBANOFF
Role PRESIDENT
Phone 4017233400

Taxonomy

Taxonomy Code 152W00000X - Optometrist
License Number CODTG00551
State RI
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KLIBANOFF EYE ASSOCIATES, LTD. 401(K) PROFIT SHARING PLAN 2023 050384813 2024-04-05 KLIBANOFF EYE ASSOCIATES, LTD. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621320
Sponsor’s telephone number 4017233400
Plan sponsor’s address 55 BROAD STREET, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2024-04-05
Name of individual signing BENJAMIN KLIBANOFF
Valid signature Filed with authorized/valid electronic signature
KLIBANOFF EYE ASSOCIATES, LTD. 401(K) PROFIT SHARING PLAN 2022 050384813 2023-06-07 KLIBANOFF EYE ASSOCIATES, LTD. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621320
Sponsor’s telephone number 4017233400
Plan sponsor’s address 55 BROAD STREET, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2023-06-07
Name of individual signing BENJAMIN KLIBANOFF
Valid signature Filed with authorized/valid electronic signature
KLIBANOFF EYE ASSOCIATES, LTD. 401(K) PROFIT SHARING PLAN 2021 050384813 2022-02-24 KLIBANOFF EYE ASSOCIATES, LTD. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621320
Sponsor’s telephone number 4017233400
Plan sponsor’s address 55 BROAD STREET, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2022-02-24
Name of individual signing BENJAMIN KLIBANOFF
Valid signature Filed with authorized/valid electronic signature
KLIBANOFF EYE ASSOCIATES, LTD. 401(K) PROFIT SHARING PLAN 2020 050384813 2021-06-22 KLIBANOFF EYE ASSOCIATES, LTD. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621320
Sponsor’s telephone number 4017233400
Plan sponsor’s address 55 BROAD STREET, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2021-06-22
Name of individual signing BENJAMIN KLIBANOFF
Valid signature Filed with authorized/valid electronic signature
KLIBANOFF EYE ASSOCIATES, LTD. 401(K) PROFIT SHARING PLAN 2019 050384813 2020-04-08 KLIBANOFF EYE ASSOCIATES, LTD. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621320
Sponsor’s telephone number 4017233400
Plan sponsor’s address 55 BROAD STREET, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2020-04-08
Name of individual signing BENJAMIN KLIBANOFF
Valid signature Filed with authorized/valid electronic signature
KLIBANOFF EYE ASSOCIATES, LTD. 401(K) PROFIT SHARING PLAN 2018 050384813 2019-04-03 KLIBANOFF EYE ASSOCIATES, LTD. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621320
Sponsor’s telephone number 4017233400
Plan sponsor’s address 55 BROAD STREET, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2019-04-03
Name of individual signing BENJAMIN KLIBANOFF
Valid signature Filed with authorized/valid electronic signature
KLIBANOFF EYE ASSOCIATES, LTD. PROFIT SHARING PLAN 2017 050384813 2018-07-26 KLIBANOFF EYE ASSOCIATES, LTD. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621320
Sponsor’s telephone number 4017233400
Plan sponsor’s address 55 BROAD STREET, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2018-07-26
Name of individual signing BENJAMIN KLIBANOFF
Valid signature Filed with authorized/valid electronic signature
KLIBANOFF EYE ASSOCIATES, LTD. PROFIT SHARING PLAN 2016 050384813 2017-05-16 KLIBANOFF EYE ASSOCIATES, LTD. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621320
Sponsor’s telephone number 4017233400
Plan sponsor’s address 55 BROAD STREET, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2017-05-16
Name of individual signing DAVID KLIBANOFF
Valid signature Filed with authorized/valid electronic signature
KLIBANOFF EYE ASSOCIATES, LTD. PROFIT SHARING PLAN 2015 050384813 2016-03-30 KLIBANOFF EYE ASSOCIATES, LTD. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621320
Sponsor’s telephone number 4017233400
Plan sponsor’s address 55 BROAD STREET, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2016-03-30
Name of individual signing DAVID KLIBANOFF
Valid signature Filed with authorized/valid electronic signature
KLIBANOFF EYE ASSOCIATES, LTD. PROFIT SHARING PLAN 2014 050384813 2015-10-07 KLIBANOFF EYE ASSOCIATES, LTD. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621320
Sponsor’s telephone number 4017233400
Plan sponsor’s address 55 BROAD STREET, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2015-10-07
Name of individual signing DAVID KLIBANOFF
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/09/23/20140923133948P030015589111001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621320
Sponsor’s telephone number 4017233400
Plan sponsor’s address 55 BROAD STREET, PAWTUCKET, RI, 02860

Signature of

Role Plan administrator
Date 2014-09-23
Name of individual signing DAVID KLIBANOFF
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/02/20130702085506P040101247989001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621320
Sponsor’s telephone number 4017233400
Plan sponsor’s address 55 BROAD STREET, PAWTUCKET, RI, 02860

Plan administrator’s name and address

Administrator’s EIN 050384813
Plan administrator’s name KLIBANOFF EYE ASSOCIATES, LTD.
Plan administrator’s address 55 BROAD STREET, PAWTUCKET, RI, 02860
Administrator’s telephone number 4017233400

Signature of

Role Plan administrator
Date 2013-07-02
Name of individual signing DAVID KLIBANOFF
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/09/28/20120928121826P030004413205001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621320
Sponsor’s telephone number 4017233400
Plan sponsor’s address 55 BROAD STREET, PAWTUCKET, RI, 02860

Plan administrator’s name and address

Administrator’s EIN 050384813
Plan administrator’s name KLIBANOFF EYE ASSOCIATES, LTD.
Plan administrator’s address 55 BROAD STREET, PAWTUCKET, RI, 02860
Administrator’s telephone number 4017233400

Signature of

Role Plan administrator
Date 2012-09-28
Name of individual signing DAVID KLIBANOFF
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/28/20110728124635P040033036967001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621320
Sponsor’s telephone number 4017233400
Plan sponsor’s address 121 BROAD STREET, PAWTUCKET, RI, 02860

Plan administrator’s name and address

Administrator’s EIN 050384813
Plan administrator’s name KLIBANOFF EYE ASSOCIATES, LTD.
Plan administrator’s address 121 BROAD STREET, PAWTUCKET, RI, 02860
Administrator’s telephone number 4017233400

Signature of

Role Plan administrator
Date 2011-07-28
Name of individual signing DAVID KLIBANOFF
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/28/20110728131246P040474461568001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621320
Sponsor’s telephone number 4017233400
Plan sponsor’s address 121 BROAD STREET, PAWTUCKET, RI, 02860

Plan administrator’s name and address

Administrator’s EIN 050384813
Plan administrator’s name KLIBANOFF EYE ASSOCIATES, LTD.
Plan administrator’s address 121 BROAD STREET, PAWTUCKET, RI, 02860
Administrator’s telephone number 4017233400

Signature of

Role Plan administrator
Date 2011-07-28
Name of individual signing DAVID KLIBANOFF
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621320
Sponsor’s telephone number 4017233400
Plan sponsor’s address 121 BROAD STREET, PAWTUCKET, RI, 02860

Plan administrator’s name and address

Administrator’s EIN 050384813
Plan administrator’s name KLIBANOFF EYE ASSOCIATES, LTD.
Plan administrator’s address 121 BROAD STREET, PAWTUCKET, RI, 02860
Administrator’s telephone number 4017233400

Signature of

Role Plan administrator
Date 2010-09-30
Name of individual signing DAVID KLIBANOFF
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
DAVID A. KLIBANOFF Agent 55 BROAD STREET, PAWTUCKET, RI, 02860, USA

PRESIDENT

Name Role Address
BENJAMIN D KLIBANOFF PRESIDENT 55 BROAD STREET PAWTUCKET, RI 02860 USA

TREASURER

Name Role Address
BENJAMIN D KLIBANOFF TREASURER 55 BROAD STREET PAWTUCKET, RI 02860 USA

SECRETARY

Name Role Address
BENJAMIN D KLIBANOFF SECRETARY 55 BROAD STREET PAWTUCKET, RI 02860 USA

VICE PRESIDENT

Name Role Address
BENJAMIN D. KLIBANOFF VICE PRESIDENT 55 BROAD STREET PAWTUCKET, RI 02860 USA

Events

Type Date Old Value New Value
Name Change 1989-10-11 PAWTUCKET EYE ASSOCIATES, LTD. KLIBANOFF EYE ASSOCIATES, LTD.
Name Change 1980-06-10 DR. DAVID A. KLIBANOFF and DR. MAX KLIBANOFF, LTD. PAWTUCKET EYE ASSOCIATES, LTD.

Filings

Number Name File Date
202449014820 Annual Report 2024-03-21
202327464840 Annual Report 2023-02-03
202208643980 Annual Report 2022-01-26
202186001310 Annual Report 2021-01-13
202033372400 Annual Report 2020-01-30
201985323300 Annual Report 2019-01-29
201855915460 Annual Report 2018-01-10
201748388300 Annual Report 2017-08-11
201747692930 Revocation Notice For Failure to File An Annual Report 2017-07-27
201690241960 Annual Report 2016-01-08

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
2547408409 2021-02-03 0165 PPS 55 Broad St, Pawtucket, RI, 02860-2023
Loan Status Date 2021-07-20
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 150000
Loan Approval Amount (current) 150000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 15940
Servicing Lender Name Webster Bank National Association
Servicing Lender Address 137 Bank St, WATERBURY, CT, 06702-2205
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address Pawtucket, PROVIDENCE, RI, 02860-2023
Project Congressional District RI-01
Number of Employees 17
NAICS code 621320
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 15940
Originating Lender Name Webster Bank National Association
Originating Lender Address WATERBURY, CT
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 150534.25
Forgiveness Paid Date 2021-06-23
4666067300 2020-04-30 0165 PPP 55 BROAD ST, PAWTUCKET, RI, 02860
Loan Status Date 2021-05-21
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 123511
Loan Approval Amount (current) 123511
Undisbursed Amount 0
Franchise Name -
Lender Location ID 15940
Servicing Lender Name Webster Bank National Association
Servicing Lender Address 137 Bank St, WATERBURY, CT, 06702-2205
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Unanswered
Project Address PAWTUCKET, PROVIDENCE, RI, 02860-0001
Project Congressional District RI-01
Number of Employees 16
NAICS code 621320
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 15940
Originating Lender Name Webster Bank National Association
Originating Lender Address WATERBURY, CT
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 124600.6
Forgiveness Paid Date 2021-04-01

Date of last update: 06 Apr 2025

Sources: Rhode Island Department of State