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Providence Fertility Institute, Inc.

Company Details

Name: Providence Fertility Institute, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Revoked Entity
Date of Organization in Rhode Island: 01 Aug 2012 (13 years ago)
Date of Dissolution: 12 Oct 2022 (3 years ago)
Date of Status Change: 12 Oct 2022 (3 years ago)
Identification Number: 000792123
ZIP code: 02920
County: Providence County
Purpose: GYNECOLOGY, REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY Title: 7-1.2
Fictitious names: Providence Fertility Center (trading name, 2012-08-09 - )
Principal Address: Google Maps Logo 1150 RESERVOIR AVENUE SUITE 300, CRANSTON, RI, 02920, USA

Industry & Business Activity

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

Agent

Name Role Address
TAMMY A. BOTTELLA, ESQ. Agent 255 QUAKER LANE SUITE 600, WEST WARWICK, RI, 02893, USA

PRESIDENT

Name Role Address
ANNE DEVI WOLD PRESIDENT 1150 RESERVOIR AVENUE, SUITE 300 CRANSTON , RI 02920 USA

National Provider Identifier

NPI Number:
1528479227

Authorized Person:

Name:
ANN WOLD
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207VE0102X - Reproductive Endocrinology Physician
Is Primary:
No
Selected Taxonomy:
207VG0400X - Gynecology Physician
Is Primary:
Yes

Contacts:

Fax:
4013666079

Filings

Number Name File Date
202223923630 Revocation Certificate For Failure to File the Annual Report for the Year 2022-10-12
202220136420 Revocation Notice For Failure to File An Annual Report 2022-06-27
202197922990 Annual Report 2021-06-08
202196891260 Revocation Notice For Failure to File An Annual Report 2021-05-19
202036574270 Annual Report 2020-03-19

Date of last update: 30 May 2025

Sources: Rhode Island Department of State