Individual
JASON DAVID VILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1090 CRANSTON ST, CRANSTON, RI 02920-7323
(401) 943-1981
Mailing address
1090 CRANSTON ST, CRANSTON, RI 02920-7323
(019) 431-9814
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00927
RI
363AM0700X
Medical Physician Assistant
23.003522
CT
Other
Enumeration date
02/06/2016
Last updated
12/01/2025
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