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  5. Garden City Neurology, Ltd.

Garden City Neurology, Ltd.

Company Details

Name: Garden City Neurology, Ltd.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Dissolved
Date of Organization in Rhode Island: 17 Jul 2003 (22 years ago)
Date of Dissolution: 12 Jul 2023 (2 years ago)
Date of Status Change: 12 Jul 2023 (2 years ago)
Identification Number: 000133367
ZIP code: 02920
County: Providence County
Principal Address: 40 RED CEDAR DRIVE, CRANSTON, RI, 02920, USA
Purpose: PRACTICE OF MEDICINE
NAICS: 621111 - Offices of Physicians (except Mental Health Specialists)
Fictitious names: R.I. Neurodiagnostics & Rehabilitation (trading name, 2007-02-09 - )
R.I. Neurodiagnostics & Therapy (trading name, 2007-02-09 - )
R.I. Neurodiagnostic Testing Center (trading name, 2003-07-22 - )

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1639207319 2007-03-02 2020-08-22 900 RESERVOIR AVE, CRANSTON, RI, 029104417, US 900 RESERVOIR AVE, CRANSTON, RI, 029104417, US

Contacts
Phone +1 401-714-0222
Fax 4017140220

Authorized person
Name DR. RICHARD LOUIS CERVONE
Role PRESIDENT
Phone 4017140222

Taxonomy
Taxonomy Code 2084N0600X - Clinical Neurophysiology Physician
License Number MD10970
State RI
Is Primary Yes

Other Provider Identifiers
Issuer BLUE CROSS RI NUMBER
Number 26655-2
State RI
Issuer UNITED HEALTH NUMBER
Number 4400009
State RI
Issuer MEDICAID
Number GC51470
State RI
Issuer FIRST HEALTH
Number 2142223
State RI
Issuer BLUECHIP NUMBER
Number 410755
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GARDEN CITY NEUROLOGY, LTD. 401(K) PROFIT SHARING PLAN 2018 861072849 2019-10-18 GARDEN CITY NEUROLOGY, LTD. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621399
Sponsor’s telephone number 4019447847
Plan sponsor’s address 40 RED CEDAR DRIVE, CRANSTON, RI, 02920
GARDEN CITY NEUROLOGY, LTD. 401(K) PROFIT SHARING PLAN 2018 861072849 2019-06-06 GARDEN CITY NEUROLOGY, LTD. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621399
Sponsor’s telephone number 4019447847
Plan sponsor’s address 40 RED CEDAR DRIVE, CRANSTON, RI, 02920
GARDEN CITY NEUROLOGY, LTD. 401(K) PROFIT SHARING PLAN 2017 861072849 2018-07-18 GARDEN CITY NEUROLOGY, LTD. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621399
Sponsor’s telephone number 4017140222
Plan sponsor’s address 900 RESERVOIR AVE, CRANSTON, RI, 02910
GARDEN CITY NEUROLOGY, LTD. 401(K) PROFIT SHARING PLAN 2016 861072849 2017-07-24 GARDEN CITY NEUROLOGY, LTD. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621399
Sponsor’s telephone number 4017140222
Plan sponsor’s address 900 RESERVOIR AVE, CRANSTON, RI, 02910
GARDEN CITY NEUROLOGY, LTD. 401(K) PROFIT SHARING PLAN 2015 861072849 2016-06-16 GARDEN CITY NEUROLOGY, LTD. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621399
Sponsor’s telephone number 4017140222
Plan sponsor’s address 900 RESERVOIR AVE, CRANSTON, RI, 02910

Plan administrator’s name and address
Administrator’s EIN 861072849
Plan administrator’s name GARDEN CITY NEUROLOGY, LTD.
Plan administrator’s address 900 RESERVOIR AVE, CRANSTON, RI, 02910
Administrator’s telephone number 4017140222
GARDEN CITY NEUROLOGY, LTD. 401(K) PROFIT SHARING PLAN 2014 861072849 2015-07-17 GARDEN CITY NEUROLOGY, LTD. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621399
Sponsor’s telephone number 4017140222
Plan sponsor’s address 900 RESERVOIR AVE, CRANSTON, RI, 02910

Plan administrator’s name and address
Administrator’s EIN 861072849
Plan administrator’s name GARDEN CITY NEUROLOGY, LTD.
Plan administrator’s address 900 RESERVOIR AVE, CRANSTON, RI, 02910
Administrator’s telephone number 4017140222

Signature of
Role Plan administrator
Date 2015-07-17
Name of individual signing RICHARD CERVONE
Valid signature Filed with authorized/valid electronic signature
GARDEN CITY NEUROLOGY, LTD. 401(K) PROFIT SHARING PLAN 2013 861072849 2014-07-28 GARDEN CITY NEUROLOGY, LTD. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621399
Sponsor’s telephone number 4017140222
Plan sponsor’s address 900 RESERVOIR AVE, CRANSTON, RI, 02910

Plan administrator’s name and address
Administrator’s EIN 861072849
Plan administrator’s name GARDEN CITY NEUROLOGY, LTD.
Plan administrator’s address 900 RESERVOIR AVE, CRANSTON, RI, 02910
Administrator’s telephone number 4017140222

Signature of
Role Plan administrator
Date 2014-07-28
Name of individual signing RICHARD CERVONE
Valid signature Filed with authorized/valid electronic signature
GARDEN CITY NEUROLOGY, LTD. 401(K) PROFIT SHARING PLAN 2012 861072849 2013-07-16 GARDEN CITY NEUROLOGY, LTD. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621399
Sponsor’s telephone number 4017140222
Plan sponsor’s address 900 RESERVOIR AVE, CRANSTON, RI, 02910

Plan administrator’s name and address
Administrator’s EIN 861072849
Plan administrator’s name GARDEN CITY NEUROLOGY, LTD.
Plan administrator’s address 900 RESERVOIR AVE, CRANSTON, RI, 02910
Administrator’s telephone number 4017140222

Signature of
Role Plan administrator
Date 2013-07-16
Name of individual signing RICHARD CERVONE
Valid signature Filed with authorized/valid electronic signature
GARDEN CITY NEUROLOGY, LTD. 401(K) PROFIT SHARING PLAN 2011 861072849 2012-06-06 GARDEN CITY NEUROLOGY, LTD. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621399
Sponsor’s telephone number 4017140222
Plan sponsor’s address 900 RESERVOIR AVE, CRANSTON, RI, 02910

Plan administrator’s name and address
Administrator’s EIN 861072849
Plan administrator’s name GARDEN CITY NEUROLOGY, LTD.
Plan administrator’s address 900 RESERVOIR AVE, CRANSTON, RI, 02910
Administrator’s telephone number 4017140222

Signature of
Role Plan administrator
Date 2012-06-06
Name of individual signing RICHARD CERVONE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
DAVID H. FERRARA Agent 21 GARDEN CITY DRIVE, CRANSTON, RI, 02920, USA

TREASURER

Name Role Address
LORI A. CERVONE TREASURER 40 RED CEDAR DRIVE CRANSTON, RI 02920 USA

SECRETARY

Name Role Address
TAYLOR N. CERVONE SECRETARY 40 RED CEDAR DRIVE CRANSTON, RI 02920 USA

PRESIDENT

Name Role Address
LORI A CERVONE PRESIDENT 40 RED CEDAR DRIVE CRANSTON, RI 02920 USA

Filings

Number Name File Date
202339390450 Articles of Dissolution 2023-07-12
202332584180 Annual Report 2023-04-07
202217842200 Annual Report 2022-05-26
202193684720 Annual Report 2021-03-05
202034444070 Annual Report 2020-02-12
201985933400 Annual Report 2019-02-04
201857732560 Annual Report 2018-02-05
201737288000 Annual Report 2017-03-03
201692767350 Annual Report 2016-02-19
201557647010 Annual Report 2015-03-16

Related by officers

DAVID H. FERRARA

CARTIER BROTHERS, INCORPORATED CHRISTY'S AUTO SALES, INC. CLIFT'S LIQUORS, INC. Crossman Corporation WESCO OIL COMPANY HL Liquidating Corporation CHRISTY'S AUTO RENTALS INC. Metal Findings Manufacturers Association, Inc. FUN TIME RESTAURANT, INC. La Fogata, Inc.

LORI A CERVONE

MPG REALTY, LLC

Related by address

40 RED CEDAR DRIVE, CRANSTON, RI, 02920, USA

MPG REALTY, LLC

Date of last update: 09 Oct 2024

Sources: Rhode Island Department of State

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