| Name: | LINDA J. HANNA-TRAD, M.D., INC. |
| Jurisdiction: | Rhode Island |
| Entity type: | Professional Service Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 07 Mar 2016 (9 years ago) |
| Identification Number: | 001661077 |
| ZIP code: | 02904 |
| County: | Providence County |
| Principal Address: | 185A HIGH SERVICE AVENUE, NORTH PROVIDENCE, RI, 02904, USA |
| Purpose: | MEDICAL OFFICE |
| NAICS: | 621111 - Offices of Physicians (except Mental Health Specialists) |
| Fictitious names: |
LINDA J. HANNA-TRAD, M.D. (trading name, 2016-03-10 - ) |
| Historical names: |
LINDA HANNA-TRAD, M.D., INC. |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316300064 | 2016-03-31 | 2016-03-31 | 185A HIGH SERVICE AVE, NORTH PROVIDENCE, RI, 029045114, US | 185A HIGH SERVICE AVE, NORTH PROVIDENCE, RI, 029045114, US | |||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 401-556-1533 |
Authorized person
| Name | DR. LINDA JANE HANNA-TRAD |
| Role | PRESIDENT |
| Phone | 4015561533 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | 09017 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | TUFTS |
| Number | 009017 |
| State | RI |
| Issuer | UNITED HEALTH |
| Number | 0401886 |
| State | RI |
| Issuer | NEIGHBORHOOD HEALTH |
| Number | 4186 |
| State | RI |
| Issuer | MEDICAID |
| Number | 7004900 |
| State | RI |
| Issuer | MEDICARE |
| Number | 007006522 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| JOSEPH A. SCIACCA | Agent | 121 PHENIX AVENUE, CRANSTON, RI, 02920, USA |
| Name | Role | Address |
|---|---|---|
| LINDA J. HANNA-TRAD MD | PRESIDENT | 25 LENNON ROAD LINCOLN, RI 02865 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 2016-03-10 | LINDA HANNA-TRAD, M.D., INC. | LINDA J. HANNA-TRAD, M.D., INC. |
| Number | Name | File Date |
|---|---|---|
| 202450263170 | Annual Report | 2024-04-05 |
| 202336368560 | Annual Report | 2023-07-10 |
| 202338152770 | Revocation Notice For Failure to File An Annual Report | 2023-06-19 |
| 202222448440 | Annual Report | 2022-08-25 |
| 202220174350 | Revocation Notice For Failure to File An Annual Report | 2022-06-27 |
| 202195164860 | Annual Report | 2021-03-29 |
| 202036756450 | Annual Report | 2020-03-24 |
| 201988180360 | Annual Report | 2019-03-04 |
| 201860646690 | Annual Report | 2018-03-19 |
| 201733942500 | Annual Report | 2017-02-10 |
Date of last update: 26 Oct 2024
Sources: Rhode Island Department of State
