| Name: | Pediatric & Adolescent Endocrinology, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Dissolved |
| Date of Organization in Rhode Island: | 22 May 2009 (16 years ago) |
| Date of Dissolution: | 22 Nov 2011 (13 years ago) |
| Date of Status Change: | 22 Nov 2011 (13 years ago) |
| Identification Number: | 000507024 |
| ZIP code: | 02910 |
| County: | Providence County |
| Principal Address: | 725 RESERVOIR AVENUE SUITE 306, CRANSTON, RI, 02910, USA |
| Purpose: | MEDICAL DOCTOR |
| Historical names: |
Penny Kadmon M.D., Inc. |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245466390 | 2009-06-03 | 2010-12-20 | PO BOX 2337, PROVIDENCE, RI, 029060337, US | 725 RESERVOIR AVE, SUITE 306, CRANSTON, RI, 029104448, US | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Phone | +1 401-780-5557 |
Authorized person
| Name | DR. PENNY KADMON |
| Role | PRESIDENT |
| Phone | 4017805557 |
Taxonomy
| Taxonomy Code | 2080P0205X - Pediatric Endocrinology Physician |
| License Number | MD09667 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 7008664 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| PENNY KADMON | Agent | 725 RESERVOIR AVENUE SUITE 306, CRANSTON, RI, 02910, USA |
| Name | Role | Address |
|---|---|---|
| PENNY KADMON | PRESIDENT | 725 RESERVOIR AVENUE, SUITE 306 CRANSTON, RI 02910 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2010-01-26 | Penny Kadmon M.D., Inc. | Pediatric & Adolescent Endocrinology, Inc. |
| Number | Name | File Date |
|---|---|---|
| 201185179770 | Articles of Dissolution | 2011-11-22 |
| 201173956970 | Annual Report | 2011-01-21 |
| 201057439700 | Annual Report | 2010-01-26 |
| 201057430680 | Articles of Amendment | 2010-01-26 |
| 200948814170 | Statement of Change of Registered Office by the Registered Agent | 2009-08-04 |
| 200945875840 | Articles of Incorporation | 2009-05-22 |
Date of last update: 14 Oct 2024
Sources: Rhode Island Department of State
