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Westerly Family Practice, LLC

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Company Details

Name: Westerly Family Practice, LLC
Jurisdiction: Rhode Island
Entity type: Domestic Limited Liability Company
Status: Revoked Entity
Date of Organization in Rhode Island: 14 Sep 2004 (21 years ago)
Date of Dissolution: 15 Jun 2009 (16 years ago)
Date of Status Change: 15 Jun 2009 (16 years ago)
Identification Number: 000142814
ZIP code: 02891
County: Washington County
Purpose: PHYSICIAN
Principal Address: Google Maps Logo 62 WELLS STREET, WESTERLY, RI, 02891, USA

Agent

Name Role Address
RICAHRD C. PANCIERA, ESQ. Agent 53 HIGH STREET SUITE 26, WESTERLY, RI, 02891-, USA

National Provider Identifier

NPI Number:
1174718639

Authorized Person:

Name:
HARTMUT DOERWALDT
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Filings

Number Name File Date
200946453290 Revocation Certificate For Failure to File the Annual Report for the Year 2009-06-15
200944462320 Revocation Notice For Failure to File An Annual Report 2009-03-25
200701409430 Annual Report 2007-09-24

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Date of last update: 15 Jun 2025

Sources: Rhode Island Department of State