| Name: | New England Pain Associates, P.C. |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Corporation |
| Status: | Revoked Entity |
| Date of Organization in Rhode Island: | 30 Nov 2005 (19 years ago) |
| Date of Dissolution: | 20 Oct 2008 (16 years ago) |
| Date of Status Change: | 20 Oct 2008 (16 years ago) |
| Identification Number: | 000152138 |
| ZIP code: | 02915 |
| County: | Providence County |
| Place of Formation: | MASSACHUSETTS |
| Principal Address: | 42 HEMINGWAY DRIVE, EAST PROVIDENCE, RI, 02915-, USA |
| Purpose: | PHYSICIAN MEDICAL PRACTICE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265730162 | 2011-03-02 | 2011-03-02 | 10 CONVERSE PL STE 4, 10 CONVERSE PLACE 4TH FLOOR, WINCHESTER, MA, 018902713, US | 1 CUMBERLAND ST STE 2B, WOONSOCKET, RI, 028953327, US | |||||||||||||||||||||||||||
|
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| Phone | +1 401-356-4260 |
| Phone | +1 617-548-5959 |
Authorized person
| Name | DR. FATHALLA MASHALI |
| Role | PRESIDENT |
| Phone | 6175485959 |
Taxonomy
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| License Number | 152670 |
| State | MA |
| Is Primary | Yes |
| Taxonomy Code | 261QP3300X - Pain Clinic/Center |
| License Number | 152670 |
| State | MA |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| FATHALLA M. MASHALI, MD | Agent | 25 JOHN CUMMINGS WAY, WOONSOCKET, RI, 02895-, USA |
| Name | Role | Address |
|---|---|---|
| FATHALLA M MASHALI MD | PRESIDENT | 42 HEMINGWAY DRIVE EAST PROVIDENCE, RI 02915- USA |
| Number | Name | File Date |
|---|---|---|
| 200836729920 | Revocation Certificate For Failure to File the Annual Report for the Year | 2008-10-20 |
| 200813173100 | Revocation Notice For Failure to File An Annual Report | 2008-08-04 |
Date of last update: 09 Oct 2024
Sources: Rhode Island Department of State
