| Name: | PROVIDENCE EYE ASSOCIATES, INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 22 Aug 1997 (27 years ago) |
| Identification Number: | 000096519 |
| ZIP code: | 02908 |
| County: | Providence County |
| Principal Address: | 50 MAUDE STREET, PROVIDENCE, RI, 02908, USA |
| Purpose: | TO RENDER MEDICAL SERVICES, INCLUDING OPTOMETRY AND OPHTHALMOLOGY |
| NAICS: | 621999 - All Other Miscellaneous Ambulatory Health Care Services |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619036589 | 2006-12-07 | 2010-07-06 | 50 MAUDE ST, PROVIDENCE, RI, 029084325, US | 50 MAUDE ST, PROVIDENCE, RI, 029084325, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 401-351-5664 |
| Fax | 4014565726 |
Authorized person
| Name | DR. THOMAS PAUL CESARO |
| Role | VICE PRESIDENT |
| Phone | 4013515664 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 9007882 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| KATHLEEN G. DI MURO, ESQ. | Agent | 916 RESERVOIR AVENUE, CRANSTON, RI, 02910, USA |
| Name | Role | Address |
|---|---|---|
| GREG SCOTT LEVIN | PRESIDENT | 50 MAUDE STREET PROVIDENCE, RI 02908 USA |
| Number | Name | File Date |
|---|---|---|
| 202452760820 | Annual Report | 2024-04-23 |
| 202331459830 | Annual Report | 2023-03-22 |
| 202211160490 | Annual Report | 2022-02-16 |
| 202193852660 | Annual Report | 2021-03-11 |
| 202035072650 | Annual Report | 2020-02-21 |
| 201989162040 | Annual Report | 2019-03-22 |
| 201859315950 | Annual Report | 2018-02-27 |
| 201737217460 | Annual Report | 2017-03-02 |
| 201737163640 | Statement of Change of Registered/Resident Agent | 2017-03-02 |
| 201695343290 | Annual Report | 2016-03-28 |
Date of last update: 08 Oct 2024
Sources: Rhode Island Department of State
