| 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) |
| 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
