| Name: | Urologic Surgeons of New England, P.C. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 25 Jun 1992 (33 years ago) |
| Date of Dissolution: | 06 Apr 2012 (13 years ago) |
| Date of Status Change: | 06 Apr 2012 (13 years ago) |
| Identification Number: | 000068728 |
| ZIP code: | 02904 |
| County: | Providence County |
| Principal Address: | 125 CORLISS STREET 2ND LEVEL, PROVIDENCE, RI, 02904, USA |
| Purpose: | PROVIDING PROFESSIONAL MEDICAL CARE AND SERVICES. |
| Fictitious names: |
PRO/CaRE/The Prostate Cancer Care Group (trading name, 1999-09-07 - 2000-09-14) |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609960590 | 2006-10-03 | 2008-01-30 | 125 CORLISS ST, 2ND LEVEL, PROVIDENCE, RI, 029042611, US | 125 CORLISS ST, 2ND LEVEL, PROVIDENCE, RI, 029042611, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 401-274-6565 |
| Fax | 4013312370 |
Authorized person
| Name | RHONDA BENZONI |
| Role | BILLING SPECIALIST |
| Phone | 4018618400 |
Taxonomy
| Taxonomy Code | 208800000X - Urology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NHP |
| Number | 10059 |
| State | RI |
| Issuer | BCBS RI |
| Number | 25692 |
| State | RI |
| Issuer | TUFTS |
| Number | 008242 |
| State | RI |
| Issuer | AETNA |
| Number | 0004673110 |
| State | RI |
| Issuer | AETNA |
| Number | 0007759013 |
| State | RI |
| Issuer | NHP GROUP |
| Number | 1087 |
| State | RI |
| Issuer | HARVARD PILGRIM HEALTHCAR |
| Number | 27125 |
| State | RI |
| Issuer | HARVARD PILGRIM HEALTHCAR |
| Number | 27180 |
| State | RI |
| Issuer | HARVARD PILGRIM HEALTHCAR |
| Number | AA51691 |
| State | RI |
| Issuer | TUFTS |
| Number | 005102 |
| State | RI |
| Issuer | UNITED HEALTH CARE |
| Number | 1900145 |
| State | RI |
| Issuer | UNITED HEALTH CARE |
| Number | 1900147 |
| State | RI |
| Issuer | TUFTS |
| Number | 797515 |
| State | RI |
| Issuer | NHP |
| Number | 10058 |
| State | RI |
| Issuer | UNITED HEALTH CARE |
| Number | 1900216 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| SUSAN LEACH DEBLASIO, ESQ. | Agent | ADLER POLLOCK & SHEEHAN P.C. ONE CITIZENS PLAZA 8TH FLOOR, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| PATRICK J KELTY MD | SECRETARY | 125 CORLISS ST PROVIDENCE, RI 02904 USA |
| Name | Role | Address |
|---|---|---|
| STEVEN I COHEN MD | PRESIDENT | 125 CORLISS STREET PROVIDENCE, RI 02904 USA |
| Name | Role | Address |
|---|---|---|
| STEPHEN F SCHIFF MD | VICE PRESIDENT | 125 CORLISS STREET PROVIDENCE, RI 02904 USA |
| PATRICK J KELTY MD | VICE PRESIDENT | 125 CORLISS ST PROVIDENCE, RI 02904 USA |
| Name | Role | Address |
|---|---|---|
| STEVEN I COHEN MD | DIRECTOR | 125 CORLISS STREET PROVIDENCE, RI 02904 USA |
| PATRICK J KELTY MD | DIRECTOR | 125 CORLISS STREET PROVIDENCE, RI 02904 USA |
| STEPHEN F SCHIFF MD | DIRECTOR | 125 CORLISS STREET PROVIDENCE, RI 02904 USA |
| Number | Name | File Date |
|---|---|---|
| 201291973350 | Miscellaneous Filing (No Fee) | 2012-04-16 |
| 201291743700 | Revocation Certificate For Failure to Maintain a Registered Agent | 2012-04-06 |
| 201288882180 | Revocation Notice For Failure to Maintain a Registered Agent | 2012-02-02 |
| 201187250260 | Agent Resigned | 2011-12-21 |
| 201174997350 | Annual Report | 2011-02-16 |
| 201060760330 | Annual Report | 2010-03-19 |
| 200944118740 | Annual Report | 2009-03-24 |
| 200810644900 | Statement of Change of Registered/Resident Agent Office | 2008-05-07 |
| 200810026580 | Annual Report | 2008-04-16 |
Date of last update: 07 Oct 2024
Sources: Rhode Island Department of State
