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  5. NEUROSURGERY FOUNDATION, INC.

NEUROSURGERY FOUNDATION, INC.

Company Details

Name: NEUROSURGERY FOUNDATION, INC.
Jurisdiction: Rhode Island
Entity type: Domestic Non-Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 13 May 1985 (40 years ago)
Identification Number: 000034475
ZIP code: 02903
County: Providence County
Principal Address: 593 EDDY STREET APC BUILDING 6TH FLOOR, PROVIDENCE, RI, 02903, USA
Purpose: PROVIDING EDUCATIONAL SERVICES IN THE PRACTICE OF NEUROSURGERY
NAICS: 813212 - Voluntary Health Organizations
Historical names: RIH Neurosurgery Foundation , Inc.

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1265419972 2005-12-23 2020-08-22 55 CLAVERICK ST, PROVIDENCE, RI, 029034144, US 55 CLAVERICK ST, PROVIDENCE, RI, 029034144, US

Contacts
Phone +1 401-490-4162

Authorized person
Name ELLEN MATESANZ
Role PRACTICE ADMINISTRATOR
Phone 4014904143

Taxonomy
Taxonomy Code 207T00000X - Neurological Surgery Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NEUROSURGERY FOUNDATION, INC. 403(B) PLAN 2015 050414462 2016-10-31 NEUROSURGERY FOUNDATION, INC. 31
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1986-10-01
Business code 621111
Sponsor’s telephone number 4014551749
Plan sponsor’s address 593 EDDY STREET, APC 6TH FLOOR, PROVIDENCE, RI, 02903
NEUROSURGERY FOUNDATION, INC. 403(B) PLAN 2014 050414462 2016-03-03 NEUROSURGERY FOUNDATION, INC. 22
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1986-10-01
Business code 621111
Sponsor’s telephone number 4014551749
Plan sponsor’s address 593 EDDY STREET, APC 6TH FLOOR, PROVIDENCE, RI, 029030000
NEUROSURGERY FOUNDATION, INC. RETIREMENT PLAN 2014 050414462 2016-02-25 NEUROSURGERY FOUNDATION, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-10-01
Business code 621111
Sponsor’s telephone number 4017939130
Plan sponsor’s address 593 EDDY STREET, APC, 6TH FLOOR, PROVIDENCE, RI, 02903
NEUROSURGERY FOUNDATION, INC. RETIREMENT PLAN 2013 050414462 2015-01-14 NEUROSURGERY FOUNDATION, INC. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-10-01
Business code 621111
Sponsor’s telephone number 4017939130
Plan sponsor’s address 593 EDDY STREET, APC, 6TH FLOOR, PROVIDENCE, RI, 02903
NEUROSURGERY FOUNDATION, INC. 403(B) PLAN 2013 050414462 2015-03-04 NEUROSURGERY FOUNDATION, INC. 22
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1986-10-01
Business code 621111
Sponsor’s telephone number 4014551749
Plan sponsor’s address 593 EDDY STREET, APC 6TH FLOOR, PROVIDENCE, RI, 02903
NEUROSURGERY FOUNDATION, INC. RETIREMENT PLAN 2012 050414462 2013-12-04 NEUROSURGERY FOUNDATION, INC. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-10-01
Business code 621111
Sponsor’s telephone number 4017939130
Plan sponsor’s address 593 EDDY STREET, APC, 6TH FLOOR, PROVIDENCE, RI, 02903

Signature of
Role Plan administrator
Date 2013-12-02
Name of individual signing CURTIS DOBERSTEIN
Valid signature Filed with authorized/valid electronic signature
NEUROSURGERY FOUNDATION, INC. 403(B) PLAN 2012 050414462 2014-01-06 NEUROSURGERY FOUNDATION, INC. 24
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1986-10-01
Business code 621111
Sponsor’s telephone number 4014551749
Plan sponsor’s address 593 EDDY STREET, APC 6TH FLOOR, PROVIDENCE, RI, 02903

Signature of
Role Plan administrator
Date 2014-01-06
Name of individual signing CURTIS DOBERSTEIN
Valid signature Filed with authorized/valid electronic signature
NEUROSURGERY FOUNDATION, INC. RETIREMENT PLAN 2011 050414462 2013-01-24 NEUROSURGERY FOUNDATION, INC. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-10-01
Business code 621111
Sponsor’s telephone number 4017939130
Plan sponsor’s address 593 EDDY STREET, APC, 6TH FLOOR, PROVIDENCE, RI, 02903

Plan administrator’s name and address
Administrator’s EIN 050414462
Plan administrator’s name NEUROSURGERY FOUNDATION, INC.
Plan administrator’s address 593 EDDY STREET, APC, 6TH FLOOR, PROVIDENCE, RI, 02903
Administrator’s telephone number 4017939130

Signature of
Role Plan administrator
Date 2013-01-23
Name of individual signing ELLEN MATESANZ
Valid signature Filed with authorized/valid electronic signature
NEUROSURGERY FOUNDATION, INC. 403(B) PLAN 2011 050414462 2013-05-15 NEUROSURGERY FOUNDATION, INC. 24
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1986-10-01
Business code 621111
Sponsor’s telephone number 4014551749
Plan sponsor’s address 593 EDDY STREET, APC 6TH FLOOR, PROVIDENCE, RI, 02903

Plan administrator’s name and address
Administrator’s EIN 050414462
Plan administrator’s name NEUROSURGERY FOUNDATION, INC.
Plan administrator’s address 593 EDDY STREET, APC 6TH FLOOR, PROVIDENCE, RI, 02903
Administrator’s telephone number 4014551749

Signature of
Role Plan administrator
Date 2013-05-15
Name of individual signing CURTIS DOBERSTEIN
Valid signature Filed with authorized/valid electronic signature
NEUROSURGERY FOUNDATION, INC. RETIREMENT PLAN 2010 050414462 2012-04-24 NEUROSURGERY FOUNDATION, INC. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1986-10-01
Business code 621111
Sponsor’s telephone number 4017939130
Plan sponsor’s address 593 EDDY STREET, APC 6TH FLOOR, PROVIDENCE, RI, 02903

Plan administrator’s name and address
Administrator’s EIN 050414462
Plan administrator’s name NEUROSURGERY FOUNDATION, INC.
Plan administrator’s address 593 EDDY STREET, APC 6TH FLOOR, PROVIDENCE, RI, 02903
Administrator’s telephone number 4017939130

Signature of
Role Plan administrator
Date 2012-04-24
Name of individual signing CURIS DOBERSTEIN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/04/24/20120424104916P030004674705002.pdf
Three-digit plan number (PN) 003
Effective date of plan 1986-10-01
Business code 621111
Sponsor’s telephone number 4017939130
Plan sponsor’s address 593 EDDY STREET, APC 6TH FLOOR, PROVIDENCE, RI, 02903

Plan administrator’s name and address
Administrator’s EIN 050414462
Plan administrator’s name NEUROSURGERY FOUNDATION, INC.
Plan administrator’s address 593 EDDY STREET, APC 6TH FLOOR, PROVIDENCE, RI, 02903
Administrator’s telephone number 4017939130

Signature of
Role Plan administrator
Date 2012-04-24
Name of individual signing CURTIS DOBERSTEIN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/04/28/20110428131500P040232809328001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1986-10-01
Business code 621111
Sponsor’s telephone number 4014551749
Plan sponsor’s address 55 CLAVERICK STREET, PROVIDENCE, RI, 02903

Plan administrator’s name and address
Administrator’s EIN 050414462
Plan administrator’s name NEUROSURGERY FOUNDATION, INC.
Plan administrator’s address 55 CLAVERICK STREET, PROVIDENCE, RI, 02903
Administrator’s telephone number 4014551749

Signature of
Role Plan administrator
Date 2011-04-28
Name of individual signing CURTIS DOBERSTEIN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/04/28/20110428124440P040232752720001.pdf
Three-digit plan number (PN) 003
Effective date of plan 1986-10-01
Business code 621111
Sponsor’s telephone number 4014551749
Plan sponsor’s address 55 CLAVERICK STREET, PROVIDENCE, RI, 02901

Plan administrator’s name and address
Administrator’s EIN 050414462
Plan administrator’s name NEUROSURGERY FOUNDATION, INC.
Plan administrator’s address 55 CLAVERICK STREET, PROVIDENCE, RI, 02901
Administrator’s telephone number 4014551749

Signature of
Role Plan administrator
Date 2011-04-28
Name of individual signing CURTIS DOBERSTEIN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ELIZABETH O. MANCHESTER Agent 40 WESTMINSTER STREET SUITE 1100, PROVIDENCE, RI, 02903, USA

PRESIDENT

Name Role Address
ZIYA GOKASLAN MD PRESIDENT 593 EDDY STREET PROVIDENCE, RI 02903 USA

TREASURER

Name Role Address
MUSTAFA MAZLUMOGLU TREASURER 593 EDDY STREET, APC 6 PROVIDENCE, RI 02903 USA

SECRETARY

Name Role Address
ADETOKUNBO OYELESE SECRETARY 593 EDDY STREET, APC 6 PROVIDENCE, RI 02903 USA

VICE PRESIDENT

Name Role Address
CURTIS DOBERSTEIN VICE PRESIDENT 593 EDDY STREET, APC 6 PROVIDENCE, RI 02903 USA

DIRECTOR

Name Role Address
ZIYA L GOKASLAN DIRECTOR 593 EDDY STREET, APC 6 PROVIDENCE, RI 02903 USA
ADETOKUNBO OYELESE DIRECTOR 593 EDDY STREET, APC 6 PROVIDENCE, RI 02903 USA
MUSTAFA MAZLUMOGLU DIRECTOR 593 EDDY STREET, APC BUILDING, 6TH FLOOR PROVIDENCE, RI 02903 USA
CURTIS DOBERSTEIN DIRECTOR 593 EDDY STREET PROVIDENCE, RI 02903 USA

Events

Type Date Old Value New Value
Name Change 1988-11-04 RIH Neurosurgery Foundation , Inc. NEUROSURGERY FOUNDATION, INC.

Filings

Number Name File Date
202447878000 Annual Report 2024-03-05
202333777400 Annual Report 2023-04-24
202221235050 Annual Report 2022-07-13
202220430320 Revocation Notice For Failure to File An Annual Report 2022-06-28
202198703200 Annual Report 2021-06-28
202043998030 Annual Report 2020-07-01
201999988430 Statement of Change of Registered/Resident Agent 2019-06-28
201999487050 Annual Report 2019-06-26
201986486590 Annual Report 2019-02-12
201985478640 Revocation Notice For Failure to File An Annual Report 2019-01-30

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 06 Oct 2024

Sources: Rhode Island Department of State

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