OrganizationActive
Physician Assist LLC
NPI 1669702569 · Surgical Physician Assistant · Wakefield, RI
Provider details
- NPI number
- 1669702569
- Entity type
- Organization
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Michael Cobb, Owner(401) 265-4553
- License
- PA00255 (RI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
35 Broad Rock Rd
Wakefield, RI 02879-1872
Phone: (401) 265-4553
Approximate (ZIP-level) locationGet directions
Mailing address
35 Broad Rock Rd
Wakefield, RI 02879-1872
Registry dates
- Enumerated
- 2009-12-28
- Last updated
- 2009-12-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.