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1104318427
NICHOLAS IVAR COOKSON
WARWICK, RI
NPI
1104318427
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: RI PA01048)
Additional Taxonomies
363A00000X Physician Assistant
Enumeration Date
2018-06-01
Last Update Date
2021-05-21
Business Address
NICHOLAS IVAR COOKSON
127 PROSPECT ST
WARWICK, RI 02886-7138
Phone number: 401-595-7832
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Mailing Address
NICHOLAS IVAR COOKSON
117 ELLENFIELD ST STE 101
PROVIDENCE, RI 02905-4541
Phone number: 401-444-6779
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