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RICHARD P. IACOBUCCI, M.D., INC.

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Company Details

Name: RICHARD P. IACOBUCCI, M.D., INC.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Revoked Entity
Date of Organization in Rhode Island: 08 Dec 1976 (49 years ago)
Date of Dissolution: 30 Dec 2020 (5 years ago)
Date of Status Change: 30 Dec 2020 (5 years ago)
Identification Number: 000018739
ZIP code: 02910
City: Cranston
County: Providence County
Purpose: PRACTICE OF MEDICINE
Fictitious names: Cardiovascular Study Center (trading name, 2002-01-09 - )
North Providence Center for Health Management (trading name, 1997-08-15 - )
Principal Address: Google Maps Logo 725 RESERVOIR AVENUE UNIT 103, CRANSTON, RI, 02910, USA

Industry & Business Activity

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

Agent

Name Role Address
LAW OFFICES OF RICHARD PALUMBO, LLC Agent 535 ATWOOD AVENUE SUITE 4, CRANSTON, RI, 02920, USA

PRESIDENT

Name Role Address
RICHARD P. IACOBUCCI PRESIDENT 1150 RESERVOIR AVENUE, UNIT 203 CRANSTON, RI 02910 USA

TREASURER

Name Role Address
RICHARD P IACOBUCCI TREASURER 1150 RESERVOIR AVENUE, UNIT 203 CRANSTON, RI 02910 USA

SECRETARY

Name Role Address
RICHARD P IACOBUCCI SECRETARY 1150 RESERVOIR AVENUE, UNIT 203 CRANSTON, RI 02910 USA

VICE PRESIDENT

Name Role Address
RICHARD P IACOBUCCI VICE PRESIDENT 1150 RESERVOIR AVENUE, UNIT 203 CRANSTON, RI 02910 USA

National Provider Identifier

NPI Number:
1962695155

Authorized Person:

Name:
MRS. CHRISTINE R. REBELLO
Role:
BILLING SPECIALIST
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
4012703304

Form 5500 Series

Employer Identification Number (EIN):
050370460
Plan Year:
2017
Number Of Participants:
5
Sponsor's telephone number:
Plan Year:
2016
Number Of Participants:
6
Sponsor's telephone number:
Plan Year:
2015
Number Of Participants:
2
Sponsor's telephone number:
Plan Administrator / Signatory:
RICHARD IACOBUCCI(Plan administrator)
Plan Year:
2014
Number Of Participants:
4
Sponsor's telephone number:
Plan Administrator / Signatory:
RICHARD IACOBUCCI(Plan administrator)
Plan Year:
2013
Number Of Participants:
4
Sponsor's telephone number:
Plan Administrator / Signatory:
RICHARD IACOBUCCI(Plan administrator)

Filings

Number Name File Date
202082819000 Revocation Certificate For Failure to File the Annual Report for the Year 2020-12-30
202054956180 Revocation Notice For Failure to File An Annual Report 2020-09-16
201988871420 Annual Report 2019-03-19
201755107370 Annual Report 2017-12-15
201734522350 Annual Report 2017-02-22

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Date of last update: 07 Jul 2025

Sources: Rhode Island Department of State