| Name: | Atlantic Professional Services of Rhode Island, Incorporated |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 29 Mar 2004 (21 years ago) |
| Identification Number: | 000139042 |
| Principal Address: | 307 S. EVERGREEN AVE. SUITE 101, WOODBURY, NJ, 08096, USA |
| Purpose: | THE RENDERING OF PROFESSIONAL PHYSICIAN SERVICES |
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
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | Atlantic Professional Services of Rhode Island, Incorporated, NEW YORK | 3362014 | NEW YORK |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922036946 | 2006-06-29 | 2020-09-28 | PO BOX 635998, CINCINNATI, OH, 452635998, US | 100 KENYON AVENUE, WAKEFIELD, RI, 028794299, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 401-782-8000 |
Authorized person
| Name | DR. DAVID ISTVAN |
| Role | DIRECTOR |
| Phone | 5188421900 |
Taxonomy
| Taxonomy Code | 208M00000X - Hospitalist Physician |
| Is Primary | Yes |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICARE TRAVELERS RR - G |
| Number | DC9415 |
| State | RI |
| Issuer | MEDICAID |
| Number | 02821543 |
| State | NY |
| Issuer | MEDICAID |
| Number | 7003615 |
| State | RI |
| Issuer | MEDICAID |
| Number | 1018847630001 |
| State | PA |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA |
| Name | Role | Address |
|---|---|---|
| STEPHEN MURTAUGH | TREASURER/SECRETARY | 307 S EVERGREEN AVE, SUITE 101 WOODBURY, NJ 08096 USA |
| Name | Role | Address |
|---|---|---|
| LARA OWENS | ASSISTANT TREASURER | 265 BROOKVIEW CENTRE WAY, STE 400 KNOXVILLE, TN 37919 USA |
| JOHN BARRACK | ASSISTANT TREASURER | 265 BROOKVIEW CENTRE WAY, SUITE 400 KNOXVILLE, TN 37919 USA |
| Name | Role | Address |
|---|---|---|
| EUGENE JOHNSON | VICE PRESIDENT | 307 S. EVERGREEN AVE., SUITE 101 WOODBURY, NJ 08096 USA |
| HAMMAD RIZVI MD | VICE PRESIDENT | 307 S. EVERGREEN AVE., SUITE 101 WOODBURY, NJ 08096 USA |
| Name | Role | Address |
|---|---|---|
| DAVID ISTVAN MD | DIRECTOR` | 307 S. EVERGREEN AVE., SUITE 101 WOODBURY, NJ 08096 USA |
| Name | Role | Address |
|---|---|---|
| DAVID ISTVAN MD | PRESIDENT | 307 S. EVERGREEN AVE., SUITE 101 WOOIDBURY, NJ 08096 USA |
| Name | Role | Address |
|---|---|---|
| JOHN R STAIR | ASSISTANT SECRETARY | 265 BROOKVIEW CENTRE WAY, SUITE 400 KNOXVILLE, TN 37919 USA |
| Number | Name | File Date |
|---|---|---|
| 202446350570 | Annual Report | 2024-02-14 |
| 202333054510 | Annual Report | 2023-04-17 |
| 202214770560 | Annual Report | 2022-04-14 |
| 202193338560 | Annual Report | 2021-03-01 |
| 202034979680 | Annual Report | 2020-02-24 |
| 201986944450 | Annual Report | 2019-02-19 |
| 201858781710 | Annual Report | 2018-02-22 |
| 201734243930 | Annual Report | 2017-02-16 |
| 201692486530 | Annual Report | 2016-02-16 |
| 201554841790 | Annual Report | 2015-02-10 |
Date of last update: 11 Apr 2025
Sources: Rhode Island Department of State
