| Name: | LINCOLN PEDIATRIC ASSOC., INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 29 Jan 1991 (34 years ago) |
| Date of Dissolution: | 23 Dec 2024 (4 months ago) |
| Date of Status Change: | 23 Dec 2024 (4 months ago) |
| Identification Number: | 000063248 |
| ZIP code: | 02865 |
| County: | Providence County |
| Principal Address: | 6 BLACKSTONE VALLEY PLACE, LINCOLN, RI, 02865, USA |
| Purpose: | MEDICAL OFFICE |
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
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588648935 | 2005-11-30 | 2020-08-22 | 6 BLACKSTONE VALLY PLACE, SUITE 306B, LINCOLN, RI, 02865, US | 6 BLACKSTONE VALLY PLACE, SUITE 306B, LINCOLN, RI, 02865, US | |||||||||||||||||||||||||
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| Phone | +1 401-331-4021 |
| Fax | 4013344886 |
Authorized person
| Name | DR. MARTA S SOWA |
| Role | VICE PRESIDENT OWNER |
| Phone | 4013344021 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | 6923 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 7003409 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| JEFFREY D. SOWA | Agent | 78 KENWOOD STREET, CRANSTON, RI, 02907, USA |
| Name | Role | Address |
|---|---|---|
| MARTA S. SOWA | PRESIDENT | 64 CHANNEL VIEW #3 WARWICK, RI 02889 USA |
| Name | Role | Address |
|---|---|---|
| MARTA S. SOWA | TREASURER | 64 CHANNEL VIEW #3 WARWICK, RI 02889 USA |
| Name | Role | Address |
|---|---|---|
| THOMAS P HINES | SECRETARY | 50 STRATHMORE ROAD CRANSTON, RI 02905 USA |
| Name | Role | Address |
|---|---|---|
| THOMAS P HINES | VICE PRESIDENT | 50 STRATHMORE ROAD CRANSTON, RI 02905 USA |
| Number | Name | File Date |
|---|---|---|
| 202453764340 | Annual Report | 2024-05-02 |
| 202332467140 | Annual Report | 2023-04-06 |
| 202213429720 | Annual Report | 2022-03-24 |
| 202194882260 | Annual Report | 2021-03-24 |
| 202190136240 | Statement of Change of Registered Office by the Registered Agent | 2021-02-05 |
| 202189923330 | Revocation Notice For Failure to Maintain a Registered Office | 2021-02-04 |
| 202189393700 | Registered Office Not Maintained | 2021-01-20 |
| 202037018430 | Annual Report | 2020-03-31 |
| 201989278390 | Annual Report | 2019-03-26 |
| 201861191180 | Annual Report | 2018-03-29 |
Date of last update: 08 Apr 2025
Sources: Rhode Island Department of State
