| Name: | Frank P. Maggiacomo, D.O., Inc./MOC |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 09 Jul 1991 (34 years ago) |
| Identification Number: | 000064937 |
| ZIP code: | 02920 |
| County: | Providence County |
| Principal Address: | 1681 CRANSTON STREET, CRANSTON, RI, 02920, USA |
| Purpose: | PRACTICE OF MEDICINE |
| Historical names: |
Frank P. Maggiacomo, D.O., Inc. |
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 | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124217674 | 2007-10-22 | 2007-10-22 | 1681 CRANSTON ST, SUITE D, CRANSTON, RI, 029205000, US | 1681 CRANSTON ST, SUITE D, CRANSTON, RI, 029205000, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 401-946-8446 |
| Fax | 4019468340 |
Authorized person
| Name | DR. FRANK P MAGGIACOMO |
| Role | PRESIDENT |
| Phone | 4019468446 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | DO 00383 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PTAN |
| Number | 119003084 |
| State | RI |
| Issuer | MEDICAID |
| Number | FM27448 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| ROBERT RASTELLI | Agent | 1681 CRANSTON STREET SUITE D, CRANSTON, RI, 02920, USA |
| Name | Role | Address |
|---|---|---|
| FRANK P MAGGIACOMO DO | PRESIDENT | 1681 CRANSTON STREET CRANSTON, RI 02920 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2018-07-10 | Frank P. Maggiacomo, D.O., Inc. | Frank P. Maggiacomo, D.O., Inc./MOC |
| Number | Name | File Date |
|---|---|---|
| 202458596450 | Annual Report | 2024-08-06 |
| 202457124500 | Revocation Notice For Failure to File An Annual Report | 2024-06-25 |
| 202339754900 | Annual Report | 2023-07-25 |
| 202338011400 | Revocation Notice For Failure to File An Annual Report | 2023-06-19 |
| 202218676200 | Annual Report | 2022-06-21 |
| 202198512460 | Annual Report | 2021-06-22 |
| 202196756000 | Revocation Notice For Failure to File An Annual Report | 2021-05-19 |
| 202046507040 | Annual Report | 2020-07-27 |
| 201927612860 | Annual Report | 2019-11-18 |
| 201927612950 | Statement of Change of Registered/Resident Agent | 2019-11-18 |
Date of last update: 08 Apr 2025
Sources: Rhode Island Department of State
