| Name: | Cedarz Medical and Cosmedics, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 30 Jul 1990 (34 years ago) |
| Date of Dissolution: | 01 Dec 2015 (9 years ago) |
| Date of Status Change: | 01 Dec 2015 (9 years ago) |
| Identification Number: | 000061426 |
| ZIP code: | 02809 |
| County: | Bristol County |
| Principal Address: | 812 METACOM AVENUE, BRISTOL, RI, 02809, USA |
| Purpose: | GENERAL PRACTICE OF MEDICINE. |
| Historical names: |
BAAKLINI MEDICINE & PSYCHIATRY, INC. |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073797841 | 2007-12-28 | 2008-03-14 | 812 METACOM AVENUE, BRISTOL, RI, 02809, US | 812 METACOM AVE, BRISTOL, RI, 028095160, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 401-253-0025 |
Authorized person
| Name | MICHAEL Y BAAKLINI |
| Role | PRESIDENT |
| Phone | 4012530025 |
Taxonomy
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| License Number | 7640 |
| State | RI |
| Is Primary | Yes |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| License Number | 9894 |
| State | RI |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | BM35884 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| MICHAEL Y. BEAKLINI, MD | Agent | 812 METACOM AVENUE, BRISTOL, RI, 02809, USA |
| Name | Role | Address |
|---|---|---|
| MICHAEL Y BAAKLINI MD | PRESIDENT | 810 METACOM AVENUE BRISTOL, RI 02809 USA |
| Name | Role | Address |
|---|---|---|
| MICHAEL Y BAAKLINI MD | TREASURER | 810 METACOM AVENUE BRISTOL, RI 02809 USA |
| Name | Role | Address |
|---|---|---|
| MICHAEL Y BAAKLINI MD | SECRETARY | 810 METACOM AVENUE BRISTOL, RI 02809 USA |
| Name | Role | Address |
|---|---|---|
| MICHAEL Y BAAKLINI MD | ASSISTANT SECRETARY | 810 METACOM AVENUE BRISTOL, RI 02809 USA |
| Name | Role | Address |
|---|---|---|
| MICHAEL Y BAAKLINI MD | VICE PRESIDENT | 810 METACOM AVENUE BRISTOL, RI 02809 USA |
| Name | Role | Address |
|---|---|---|
| MICHAEL Y BAAKLINI MD | DIRECTOR | 810 METACOM AVENUE BRISTOL, RI 02809 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2006-06-07 | BAAKLINI MEDICINE & PSYCHIATRY, INC. | Cedarz Medical and Cosmedics, Inc. |
| Number | Name | File Date |
|---|---|---|
| 201588595320 | Revocation Certificate For Failure to File the Annual Report for the Year | 2015-12-01 |
| 201578270400 | Revocation Notice For Failure to File An Annual Report | 2015-09-08 |
| 201435986370 | Annual Report | 2014-02-22 |
| 201308960610 | Annual Report | 2013-01-11 |
| 201288603190 | Annual Report | 2012-01-28 |
| 201174913260 | Annual Report | 2011-02-15 |
| 201064172490 | Annual Report | 2010-06-23 |
| 201063084000 | Revocation Notice For Failure to File An Annual Report | 2010-06-16 |
| 200940554650 | Annual Report | 2009-01-20 |
| 200834972210 | Annual Report | 2008-09-13 |
Date of last update: 07 Oct 2024
Sources: Rhode Island Department of State
