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Dermatology Associates, Inc.

Company Details

Name: Dermatology Associates, Inc.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Revoked Entity
Date of Organization in Rhode Island: 18 Oct 2012 (13 years ago)
Date of Dissolution: 18 Oct 2019 (6 years ago)
Date of Status Change: 18 Oct 2019 (6 years ago)
Identification Number: 000793936
ZIP code: 02818
County: Kent County
Purpose: THE PRACTICE OF DERMATOLOGY
Principal Address: Google Maps Logo 1351 SOUTH COUNTY TRAIL #3 SUITE 302, EAST GREENWICH, RI, 02818, 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
SHEILA M. COOLEY, ESQ. Agent 178 DIVISION STREET, EAST GREENWICH, RI, 02818, USA

PRESIDENT

Name Role Address
MATT L. LEAVITT USA PRESIDENT 1351 SOUTH COUNTY TRAIL, BLDG3, SUITE 302 EAST GREENWICH, RI 02818 USA

TREASURER

Name Role Address
MATT L. LEAVITT TREASURER 1351 SOUTH COUNTY TRAIL, BLDG3, SUITE 302 EAST GREENWICH, RI 02818 USA

SECRETARY

Name Role Address
MATT L. LEAVITT SECRETARY 1351 SOUTH COUNTY TRAIL, BLDG3, SUITE 302 EAST GREENWICH, RI 02818 USA

DIRECTOR

Name Role Address
MATT L. LEAVITT DIRECTOR 1351 SOUTH COUNTY TRAIL, BLDG3, SUITE 302 EAST GREENWICH, RI 02818 USA

National Provider Identifier

NPI Number:
1649515313

Authorized Person:

Name:
DR. ANITA E PEDVIS-LEFTICK
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207N00000X - Dermatology Physician
Is Primary:
Yes

Contacts:

Fax:
4016322842

Form 5500 Series

Employer Identification Number (EIN):
461221226
Plan Year:
2016
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
8
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
8
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
3
Sponsors Telephone Number:

Filings

Number Name File Date
201924622060 Revocation Certificate For Failure to File the Annual Report for the Year 2019-10-18
201907123380 Revocation Notice For Failure to File An Annual Report 2019-07-24
201858106900 Annual Report - Amended 2018-02-12
201856310020 Annual Report 2018-01-18
201731173500 Annual Report 2017-01-30

Date of last update: 30 May 2025

Sources: Rhode Island Department of State