| Name: | Pratt Radiation Oncology Associates of Rhode Island, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 11 Aug 2006 (19 years ago) |
| Identification Number: | 000157931 |
| ZIP code: | 02903 |
| County: | Providence County |
| Principal Address: | RHODE ISLAND HOSPITAL PHYSICANS OFFICE BLDG 110 LOCKWOOD STREET SUITE 130, PROVIDENCE, RI, 02903, USA |
| Purpose: | FOR THE BENEFIT OF NEW ENGLAND MEDICAL CENTER HOSPITALS, INC., PROVIDE MEDICAL SERVICES TO PATIENTS OF NEMCH, CARRY ON AND PROMOTE BASIC AND APPLIED RESEARCH AND TEACHING IN THE FIELD OF MEDICINE AT NEMCH |
| NAICS: | 622110 - General Medical and Surgical Hospitals |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891843579 | 2007-01-08 | 2015-09-14 | 800 WASHINGTON ST, BOX 1013, BOSTON, MA, 021111552, US | 593 EDDY ST, PROVIDENCE, RI, 029034923, US | |||||||||||||||
|
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| Phone | +1 617-636-5000 |
| Phone | +1 401-444-4251 |
Authorized person
| Name | THEODORE BUKOWSKI |
| Role | CFO |
| Phone | 6176365000 |
Taxonomy
| Taxonomy Code | 2085R0001X - Radiation Oncology Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| JOHN DRONEY | Agent | RI HOSPITAL PHYSICIANS OFFICE 110 LOCKWOOD STREET SUITE 130, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| DAVID WAZER, MD RHODE ISLAND HOSPITAL PHYSICANS OFFICE BLD | PRESIDENT | 110 LOCKWOOD STREET, SUITE 130 PROVIDENCE, RI 02903 USA |
| Name | Role | Address |
|---|---|---|
| THOMAS DIPETRILLO MD | TREASURER | 110 LOCKWOOD STREET, SUITE 130 PROVIDENCE, RI 02903 USA |
| Name | Role | Address |
|---|---|---|
| JAROSLAW HEPEL MD | SECRETARY | 110 LOCKWOOD STREET, SUITE 130 PROVIDENCE, RI 02903 USA |
| Name | Role | Address |
|---|---|---|
| DAVID WAZER MD | DIRECTOR | 110 LOCKWOOD STREET, SUITE 130 PROVIDENCE, RI 02903 USA |
| THOMAS DIPETRILLO MD | DIRECTOR | 110 LOCKWOOD STREET, SUITE 130 PROVIDENCE, RI 02903 USA |
| JAROSLAW HEPEL MD | DIRECTOR | 110 LOCKWOOD STREET, SUITE 130 PROVIDENCE, RI 02903 USA |
| Number | Name | File Date |
|---|---|---|
| 202447043110 | Annual Report | 2024-02-22 |
| 202340237760 | Annual Report | 2023-08-09 |
| 202338471420 | Revocation Notice For Failure to File An Annual Report | 2023-06-20 |
| 202215870700 | Annual Report | 2022-04-27 |
| 202198869960 | Annual Report | 2021-06-30 |
| 202195523450 | Annual Report | 2021-04-06 |
| 202191777730 | Revocation Notice For Failure to File An Annual Report | 2021-02-17 |
| 201995714420 | Annual Report | 2019-06-07 |
| 201988161350 | Annual Report | 2019-03-05 |
| 201985525100 | Revocation Notice For Failure to File An Annual Report | 2019-01-30 |
Date of last update: 10 Oct 2024
Sources: Rhode Island Department of State
