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  5. Dr. Elissa M. Contillo, Inc.

Dr. Elissa M. Contillo, Inc.

Company Details

Name: Dr. Elissa M. Contillo, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 17 Apr 2003 (22 years ago)
Identification Number: 000131499
ZIP code: 02920
County: Providence County
Principal Address: 671 ATWOOD AVE, CRANSTON, RI, 02920, USA
Purpose: TO OPERATE AS AN OPTOMETRIST AND OPTOMOLOGY CENTER
NAICS: 813920 - Professional Organizations

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1881874196 2007-11-05 2022-02-25 671 ATWOOD AVE, CRANSTON, RI, 029205322, US 671 ATWOOD AVE, CRANSTON, RI, 029205322, US

Contacts
Phone +1 401-421-4821
Fax 4014210928

Authorized person
Name DR. ELISSA M CONTILLO
Role OWNER
Phone 4104214821

Taxonomy
Taxonomy Code 152W00000X - Optometrist
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 9007907
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DR. ELISSA M. CONTILLO, INC. 2016 510467116 2017-07-26 DR. ELISSA M. CONTILLO, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 4017398222
Plan sponsor’s address 671 ATWOOD AVENUE, CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2017-07-26
Name of individual signing ELISSA M. CONTILLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-26
Name of individual signing ELISSA M. CONTILLO
Valid signature Filed with authorized/valid electronic signature
DR. ELISSA M. CONTILLO, INC. 401K PLAN 2015 510467116 2016-10-12 DR. ELISSA M. CONTILLO, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 4017398222
Plan sponsor’s address 671 ATWOOD AVENUE, CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2016-10-12
Name of individual signing ELISSA M. CONTILLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-12
Name of individual signing ELISSA M. CONTILLO
Valid signature Filed with authorized/valid electronic signature
DR. ELISSA M. CONTILLO, INC. 401K PLAN 2014 510467116 2015-09-08 DR. ELISSA M. CONTILLO, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 4017398222
Plan sponsor’s address 671 ATWOOD AVENUE, CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2015-09-06
Name of individual signing ELISSA M. CONTILLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-09-06
Name of individual signing ELISSA M. CONTILLO
Valid signature Filed with authorized/valid electronic signature
DR. ELISSA M. CONTILLO, INC. 401K PLAN 2013 510467116 2014-08-25 DR. ELISSA M. CONTILLO, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 4017398222
Plan sponsor’s address 671 ATWOOD AVENUE, CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2014-08-25
Name of individual signing ELISSA M. CONTILLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-08-25
Name of individual signing ELISSA M. CONTILLO
Valid signature Filed with authorized/valid electronic signature
DR. ELISSA M. CONTILLO, INC. 401K PLAN 2012 510467116 2013-09-17 DR. ELISSA M. CONTILLO, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 4017398222
Plan sponsor’s address 671 ATWOOD AVENUE, CRANSTON, RI, 02920

Signature of
Role Plan administrator
Date 2013-09-16
Name of individual signing ELISSA M. CONTILLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-09-16
Name of individual signing ELISSA M. CONTILLO
Valid signature Filed with authorized/valid electronic signature
DR. ELISSA M. CONTILLO, INC. 401K PLAN 2011 510467116 2012-10-03 DR. ELISSA M. CONTILLO, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 4017398222
Plan sponsor’s address 671 ATWOOD AVENUE, CRANSTON, RI, 02920

Plan administrator’s name and address
Administrator’s EIN 510467116
Plan administrator’s name DR. ELISSA M. CONTILLO, INC.
Plan administrator’s address 671 ATWOOD AVENUE, CRANSTON, RI, 02920
Administrator’s telephone number 4017398222

Signature of
Role Plan administrator
Date 2012-10-02
Name of individual signing ELISSA M. CONTILLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-02
Name of individual signing ELISSA M. CONTILLO
Valid signature Filed with authorized/valid electronic signature
DR. ELISSA M. CONTILLO, INC. 401K PLAN 2010 510467116 2011-10-04 DR. ELISSA M. CONTILLO, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 4017398222
Plan sponsor’s address 671 ATWOOD AVENUE, CRANSTON, RI, 02920

Plan administrator’s name and address
Administrator’s EIN 510467116
Plan administrator’s name DR. ELISSA M. CONTILLO, INC.
Plan administrator’s address 671 ATWOOD AVENUE, CRANSTON, RI, 02920
Administrator’s telephone number 4017398222

Signature of
Role Plan administrator
Date 2011-10-03
Name of individual signing ELISSA M. CONTILLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-03
Name of individual signing ELISSA M. CONTILLO
Valid signature Filed with authorized/valid electronic signature
DR. ELISSA M. CONTILLO, INC. 401K PLAN 2009 510467116 2010-07-28 DR. ELISSA M. CONTILLO, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 4017398222
Plan sponsor’s address 671 ATWOOD AVENUE, CRANSTON, RI, 02920

Plan administrator’s name and address
Administrator’s EIN 510467116
Plan administrator’s name DR. ELISSA M. CONTILLO, INC.
Plan administrator’s address 671 ATWOOD AVENUE, CRANSTON, RI, 02920
Administrator’s telephone number 4017398222

Signature of
Role Plan administrator
Date 2010-07-27
Name of individual signing ELISSA M. CONTILLO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-27
Name of individual signing ELISSA M. CONTILLO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ELISSA M CONTILLO Agent DR ELISSA M CONTILLO INC 671 ATWOOD AVE, CRANSTON, RI, 02920, USA

PRESIDENT

Name Role Address
ELISSA M CONTILLO PRESIDENT 671 ATWOOD AVE CRANSTON, RI 02920 USA
ELISSA M CONTILLO INC PRESIDENT 671 ATWOOD AVE CRANSTON, RI 02920 USA

OTHER OFFICER

Name Role Address
ELISSA M CONTILLO INC OTHER OFFICER 671 ATWOOD AVE CRANSTON, RI 02920 UNI

DIRECTOR

Name Role Address
ELISSA MARIA CONTILLO DIRECTOR 671 ATWOOD AVENUE CRANSTON, RI 02920 UNI

Filings

Number Name File Date
202451078070 Statement of Change of Registered/Resident Agent 2024-04-15
202449684140 Revocation Notice For Failure to Maintain a Registered Office 2024-03-28
202447690260 Annual Report 2024-03-03
202448689380 Registered Office Not Maintained 2024-01-03
202330479190 Annual Report 2023-03-12
202217345800 Annual Report 2022-05-15
202193610710 Annual Report 2021-03-05
202038694750 Annual Report 2020-04-26
202032969070 Statement of Change of Registered/Resident Agent Office 2020-01-24
201991226170 Annual Report 2019-04-26

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 09 Oct 2024

Sources: Rhode Island Department of State

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