Individual
DR. NICHOLAS COCCOLUTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 606-4286
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 606-4286
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
CLP05854
RI
208600000X
Surgery Physician
293004
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2022
Last updated
07/05/2023
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