| 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) |
| 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 |
Date of last update: 10 Oct 2024
Sources: Rhode Island Department of State
