| Name: | WESTERLY RADIOLOGY ASSOCIATES, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 22 Dec 1982 (42 years ago) |
| Date of Dissolution: | 12 Feb 2020 (5 years ago) |
| Date of Status Change: | 12 Feb 2020 (5 years ago) |
| Identification Number: | 000017348 |
| ZIP code: | 02891 |
| County: | Washington County |
| Principal Address: | C/O YALE NEW HAVEN WESTERLY HOSPITAL 25 WELLS STREET, WESTERLY, RI, 02891, USA |
| Purpose: | DIAGNOSTIC RADIOLOGY SERVICES |
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
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | WESTERLY RADIOLOGY ASSOCIATES, INC., CONNECTICUT | 0545794 | CONNECTICUT |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053386375 | 2006-02-21 | 2018-03-17 | 116 GRANITE ST, WESTERLY, RI, 028912460, US | 116 GRANITE ST, WESTERLY, RI, 028912460, US | |||||||||||||||||
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| Phone | +1 401-596-5695 |
| Fax | 4015960170 |
Authorized person
| Name | DANIEL CHARLES DIFFIN |
| Role | PRESIDENT |
| Phone | 4013483293 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| State | RI |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WESTERLY RADIOLOGY ASSOCIATES, INC 401(K) PLAN | 2009 | 050398363 | 2010-07-27 | WESTERLY RADIOLOGY ASSOCIATES, INC | 6 | |||||||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 050398363 |
| Plan administrator’s name | WESTERLY RADIOLOGY ASSOCIATES, INC |
| Plan administrator’s address | 55 BEACH STREET, SUITE 8B2C, WESTERLY, RI, 02891 |
| Administrator’s telephone number | 4015965695 |
Signature of
| Role | Employer/plan sponsor |
| Date | 2010-07-27 |
| Name of individual signing | LAURA SCHICK |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2002-02-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4015965695 |
| Plan sponsor’s address | 55 BEACH STREET, SUITE 8B2C, WESTERLY, RI, 02891 |
Plan administrator’s name and address
| Administrator’s EIN | 050398363 |
| Plan administrator’s name | WESTERLY RADIOLOGY ASSOCIATES, INC |
| Plan administrator’s address | 55 BEACH STREET, SUITE 8B2C, WESTERLY, RI, 02891 |
| Administrator’s telephone number | 4015965695 |
Signature of
| Role | Plan administrator |
| Date | 2010-09-29 |
| Name of individual signing | LAURA SCHICK |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2010-07-27 |
| Name of individual signing | LAURA SCHICK |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| DANIEL C. DIFFIN MD | PRESIDENT | 25 WELLS STREET WESTERLY, RI 02891 USA |
| Name | Role | Address |
|---|---|---|
| MICHAEL C. NILES MD | TREASURER | 25 WELLS STREET WESTERLY, RI 02891 USA |
| Name | Role | Address |
|---|---|---|
| MICHAEL C. NILES MD | SECRETARY | 25 WELLS STREET WESTERLY, RI 02891 USA |
| Name | Role | Address |
|---|---|---|
| DANIEL C. DIFFIN MD | DIRECTOR | 25 WELLS STREET WESTERLY, RI 02891 USA |
| MICHAEL C. NILES MD | DIRECTOR | 25 WELLS WESTERLY, RI 02891 USA |
| Name | Role | Address |
|---|---|---|
| CYNTHIA J. WARREN, ESQ. | Agent | CAMERON & MITTLEMAN LLP 301 PROMENADE STREET, PROVIDENCE, RI, 02908, USA |
| Number | Name | File Date |
|---|---|---|
| 202034296390 | Annual Report | 2020-02-13 |
| 202034243510 | Articles of Dissolution | 2020-02-12 |
| 201986633020 | Annual Report | 2019-02-14 |
| 201860827800 | Annual Report | 2018-03-23 |
| 201738029990 | Annual Report | 2017-03-15 |
| 201694071130 | Annual Report | 2016-03-09 |
| 201557743370 | Annual Report | 2015-03-18 |
| 201437185870 | Annual Report | 2014-03-17 |
| 201314216880 | Annual Report | 2013-03-20 |
| 201291244810 | Annual Report | 2012-03-16 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PO | AWARD | N6264506P2068 | 2007-11-21 | 2006-07-31 | 2006-07-31 | |||||||||||||||||||||
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| Title | RADIOLOGIST @ GROTON, CT |
| NAICS Code | 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS |
| Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
| Recipient | WESTERLY RADIOLOGY ASSOCIATES, INC. |
| UEI | KJ5WPZKKCAM4 |
| Legacy DUNS | 040096463 |
| Recipient Address | 116 GRANITE STREET, WESTERLY, 02891, UNITED STATES |
Date of last update: 06 Apr 2025
Sources: Rhode Island Department of State
