| Name: | Heritage Medical Associates, P.C. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 14 Nov 2006 (18 years ago) |
| Identification Number: | 000159695 |
| ZIP code: | 02860 |
| County: | Providence County |
| Principal Address: | 131 BEECHWOOD AVENUE, PAWTUCKET, RI, 02860, USA |
| Purpose: | TO PROVIDE HEALTH CARE 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
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003982547 | 2006-11-27 | 2015-10-13 | 131 BEECHWOOD AVE, PAWTUCKET, RI, 028605409, US | 131 BEECHWOOD AVE, PAWTUCKET, RI, 028605409, US | |||||||||||||||||||||||||||
|
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| Phone | +1 401-475-1999 |
| Fax | 4014756932 |
Authorized person
| Name | DR. JOHN PETER MISKOVSKY |
| Role | PRESIDENT |
| Phone | 4014751999 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | MD 10350 |
| State | RI |
| Is Primary | Yes |
| Taxonomy Code | 213ES0103X - Foot & Ankle Surgery Podiatrist |
| License Number | CT 0816 |
| State | CT |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| ROBERT S. BRUZZI, ESQ. | Agent | 20 AUDUBON LANE, HOPE, RI, 02831-1627, USA |
| Name | Role | Address |
|---|---|---|
| JOHN P. MISKOVSKI, M.D. | PRESIDENT | 131 BEECHWOOD AVENUE PAWTUCKET, RI 02860 USA |
| Name | Role | Address |
|---|---|---|
| JOHN P. MISKOVSKY, M.D. | TREASURER | 131 BEECHWOOD AVENUE PAWTUCKET, RI 02860 USA |
| Name | Role | Address |
|---|---|---|
| JOHN P. MISKOVSKY, M.D. | SECRETARY | 131 BEECHWOOD AVENUE PAWTUCKET, RI 02860 USA |
| Name | Role | Address |
|---|---|---|
| JOHN P. MISKOVSKY, M.D. | DIRECTOR | 131 BEECHWOOD AVENUE PAWTUCKET, RI 02860 USA |
| Number | Name | File Date |
|---|---|---|
| 202454332430 | Annual Report | 2024-05-01 |
| 202448084310 | Statement of Change of Registered/Resident Agent | 2024-03-07 |
| 202335154740 | Annual Report | 2023-05-02 |
| 202208869100 | Annual Report | 2022-01-30 |
| 202194766560 | Annual Report | 2021-03-21 |
| 202036902000 | Annual Report | 2020-03-29 |
| 201900797560 | Annual Report | 2019-07-01 |
| 201861131050 | Annual Report | 2018-03-28 |
| 201748183770 | Annual Report | 2017-08-04 |
| 201747805150 | Revocation Notice For Failure to File An Annual Report | 2017-07-27 |
Date of last update: 10 Oct 2024
Sources: Rhode Island Department of State
