# JOHN L BOSSIAN

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Main Street Family Practice
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922120054
- **Authorized official:** DR. JOHN LEON BOSSIAN II DO (PHYSICIAN)
- **Authorized official phone:** (401) 789-1600

## Contact information

- **Practice address:** 66 MAIN ST, WAKEFIELD, RI 02879-3555
- **Practice address phone:** (401) 789-1600
- **Mailing address:** 66 MAIN ST, WAKEFIELD, RI 02879-3555
- **Mailing address phone:** (401) 789-1600

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | DO0391 | RI | Yes |

## Other

- **Enumeration date:** 04/06/2007
- **Last updated:** 06/17/2008