| Name: | Northeast Internal Medicine, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 05 Jun 2007 (18 years ago) |
| Identification Number: | 000164304 |
| ZIP code: | 02860 |
| County: | Providence County |
| Principal Address: | 126 PROSPECT STREET SUITE 205, PAWTUCKET, RI, 02860, USA |
| Purpose: | PRACTICE OF MEDICINE |
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 | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376746156 | 2007-06-07 | 2024-03-11 | 126 PROSPECT ST STE 205, PAWTUCKET, RI, 028604429, US | 126 PROSPECT ST, SUITE 103, PAWTUCKET, RI, 028604476, US | |||||||||||||||||||
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| Phone | +1 401-725-8866 |
| Fax | 4017258868 |
Authorized person
| Name | DR. SADIA IFTIKHAR |
| Role | DIRECTOR |
| Phone | 4017258866 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | MD10628 |
| State | RI |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTHEAST INTERNAL MEDICINE, INC. 401(K) PLAN | 2023 | 651307207 | 2024-05-10 | NORTHEAST INTERNAL MEDICINE, INC. | 3 | |||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-05-10 |
| Name of individual signing | SADIA IFTIKHAR |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2024-05-10 |
| Name of individual signing | SADIA IFTIKHAR |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4019524766 |
| Plan sponsor’s address | 126 PROSPECT STREET, SUITE 103, PAWTUCKET, RI, 02860 |
Signature of
| Role | Plan administrator |
| Date | 2023-04-28 |
| Name of individual signing | SADIA IFTIKHAR |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2023-04-28 |
| Name of individual signing | SADIA IFTIKHAR |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4019524766 |
| Plan sponsor’s address | 126 PROSPECT STREET, SUITE 103, PAWTUCKET, RI, 02860 |
Signature of
| Role | Plan administrator |
| Date | 2022-05-05 |
| Name of individual signing | SADIA IFTIKHAR |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 4019524766 |
| Plan sponsor’s address | 126 PROSPECT STREET, SUITE 103, PAWTUCKET, RI, 02860 |
Signature of
| Role | Plan administrator |
| Date | 2021-05-10 |
| Name of individual signing | SADIA IFTIKHAR |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| SADIA IFTIKHAR | Agent | 126 PROSPECT STREET, PAWTUCKET, RI, 02860, USA |
| Name | Role | Address |
|---|---|---|
| SADIA IFTIKHAR NORTHEAST | PRESIDENT | 126 PROSPECT ST STE 103 PAWTUCKET, RI 02860 USA |
| Name | Role | Address |
|---|---|---|
| JIAYING WEN | VICE PRESIDENT | 126 PROSPECT STREET, SUITE 103, SUITE 103 PAWTUCKET, RI 02860 USA |
| Name | Role | Address |
|---|---|---|
| SADIA IFTIKHAR | OTHER OFFICER | 126 PROSPECT STREET PAWTUCKET, RI 02860 UNI |
| Number | Name | File Date |
|---|---|---|
| 202446952710 | Annual Report | 2024-02-21 |
| 202326445200 | Annual Report | 2023-01-23 |
| 202208684730 | Annual Report | 2022-01-26 |
| 202187810380 | Annual Report | 2021-01-26 |
| 202034819940 | Annual Report | 2020-02-20 |
| 201984540780 | Annual Report | 2019-01-16 |
| 201856254720 | Annual Report | 2018-01-17 |
| 201729700620 | Annual Report | 2017-01-09 |
| 201690223740 | Annual Report | 2016-01-08 |
| 201557627490 | Annual Report | 2015-03-16 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4035507305 | 2020-04-29 | 0165 | PPP | 126 Prospect Street 103, Pawtucket, RI, 02860 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 10 Oct 2024
Sources: Rhode Island Department of State
