LIFESPAN PHYSICIAN GROUP, INC.

Company Details

Entity Name:	LIFESPAN PHYSICIAN GROUP, INC.
Jurisdiction:	Connecticut
Legal type:	Non-Stock
Citizenship:	Foreign
Status:	Active
Date Formed:	04 Sep 2012 (Companies founded in September 2012)
Business ALEI:	1082039
Annual report due:	04 Sep 2025
NAICS code:	621111 - Offices of Physicians (except Mental Health Specialists)
Business address:	167 POINT STREET, PROVIDENCE, RI, 02903, United States
Mailing address:	167 POINT STREET, PROVIDENCE, RI, United States, 02903
Place of Formation:	RHODE ISLAND
E-Mail:	pgordon@nixonpeabody.com

Agent

Name	Role
CORPORATION SERVICE COMPANY	Agent

Director

Name	Role	Business address	Residence address
PAUL LIU M.D.	Director	235 Plain St., Ste. 102, PROVIDENCE, RI, 02805, United States	235 Plain St., Ste. 102, PROVIDENCE, RI, 02805, United States
Julie Boergers, Ph.D.	Director	1 Hoppin St, Providence, RI, 02903, United States	1 Hoppin St, Providence, RI, 02903, United States
MICHAEL E. MIGLIORI M.D.	Director	1 HOPPIN ST., SUITE 202, PROVIDENCE, RI, 02903, United States	1 HOPPIN ST., SUITE 202, PROVIDENCE, RI, 02903, United States
LINDA DAME DNP FNP-BC	Director	SOUTH STREET LANDING, 350 EDDY ST., OFFICE 292, PROVIDENCE, RI, 02903, United States	SOUTH STREET LANDING, 350 EDDY ST., OFFICE 292, PROVIDENCE, RI, 02903, United States
Henry Sachs, M.D.	Director	593 Eddy St, Providence, RI, 02903-4923, United States	593 Eddy St, Providence, RI, 02903-4923, United States
Adetokunbo Oyelese, MD	Director	593 Eddy St, Providence, RI, 02903, United States	593 Eddy St, Providence, RI, 02903, United States
Edward McGookin, MD	Director	10 Davol Sq., Ste. 300, Providence, RI, 02903, United States	10 Davol Sq., Ste. 300, Providence, RI, 02903, United States
Anish Misri, M.D.	Director	593 Eddy St, Providence, RI, 02903-4923, United States	593 Eddy St, Providence, RI, 02903-4923, United States
JILL O'BRIEN M.D.	Director	164 SUMMIT AVE., PROVIDENCE, RI, 02906, United States	164 SUMMIT AVE., PROVIDENCE, RI, 02906, United States
Jessica Attar, MSN	Director	593 Eddy St, Providence, RI, 02903-4923, United States	593 Eddy St, Providence, RI, 02903-4923, United States
Christopher Song, M.D.	Director	208 Collyer St, Providence, RI, 02904, United States	208 Collyer St, Providence, RI, 02904, United States
PHYLLIS A. DENNERY M.D.	Director	593 EDDY ST., PROVIDENCE, RI, 02903, United States	593 EDDY ST., PROVIDENCE, RI, 02903, United States
Laura Stanton	Director	164 Summit Ave., Providence, RI, 02906, United States	164 Summit Ave., Providence, RI, 02906, United States
CURTIS E. DOBERSTEIN M.D.	Director	593 EDDY ST., PROVIDENCE, RI, 02903, United States	593 EDDY ST., PROVIDENCE, RI, 02903, United States

Officer

Name	Role	Business address	Residence address
GILDASIO S. DE OLIVEIRA,	Officer	593 EDDY ST., PROVIDENCE, RI, 02903, United States	593 EDDY ST., PROVIDENCE, RI, 02903, United States
Peter Markell, CFO	Officer	167 Point St., Ste. 2B, Providence, RI, 02903-4771, United States	167 Point St., Ste. 2B, Providence, RI, 02903-4771, United States
Babar Khokhar	Officer	167 Point Street, Ste. 2B, Providence, RI, 02903, United States	167 Point Street, Ste. 2B, Providence, RI, 02903, United States

Filing

Filing number	Filing date	Effective date	Filing category	Filing type	Report year
BF-0012077882	2024-08-09	No data	Annual Report	Annual Report	No data
BF-0011435740	2023-08-29	No data	Annual Report	Annual Report	No data
BF-0010269904	2022-09-06	No data	Annual Report	Annual Report	2022
BF-0010477750	2022-01-14	2022-01-14	Mass Agent Change � Address	Agent Address Change	No data
BF-0009812119	2021-09-15	No data	Annual Report	Annual Report	No data
0006978354	2020-09-14	No data	Annual Report	Annual Report	2020
0006943532	2020-07-06	2020-07-06	Change of Agent Address	Agent Address Change	No data
0006950703	2020-07-06	2020-07-06	Change of Agent Address	Agent Address Change	No data
0006627858	2019-08-21	No data	Annual Report	Annual Report	2019
0006284714	2018-11-29	No data	Annual Report	Annual Report	2018
0006284660	2018-11-29	No data	Annual Report	Annual Report	2015
0006284637	2018-11-29	No data	Annual Report	Annual Report	2013
0006284674	2018-11-29	No data	Annual Report	Annual Report	2016
0006284649	2018-11-29	No data	Annual Report	Annual Report	2014
0006284692	2018-11-29	No data	Annual Report	Annual Report	2017
0004711394	2012-09-04	No data	Business Registration	Certificate of Authority	No data

Date of last update: 11 Nov 2024

Sources: Connecticut's Official State Website