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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JAKE T BROCCOLO, DPT

Active

JAKE T BROCCOLO, DPT is a Physical Therapy Assistant healthcare provider located in NORTH PROVIDENCE, Rhode Island. NPI 1144709114 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · NORTH PROVIDENCE, RI

Registration Details

NPI Number
1144709114
Provider Type
Individual
Gender
Male
NPI Issued
Aug 10, 2018 (7.9729330619157 yrs)
Last Updated
Jan 30, 2026
Licenses
PTL88684 (MA)
PT03093 (RI)

Practice Information

Address
1401 DOUGLAS AVE
NORTH PROVIDENCE, RI, 029044058
Browse RI providers · Browse ZIP 02904
Phone
4017267100
Primary Specialty
Physical Therapy Assistant
225100000X
Additional Specialty
Physical Therapy Assistant

Other Physical Therapy Assistant Providers in NORTH PROVIDENCE, RI

Name Credential NPI
ROBERT JOSEPH SCLAMA JR. MSPT 1770557902
MR. MELISSA A. BRUNELLE P.T. 1962587931
MS. SUSAN M ALMEIDA MSPT 1154497451
MS. MILVA CATALLOZZI MS.,PT 1205902228
JOSHUA J. PERRY P.T. 1760522973
MR. FRANKLIN CORDERO II PT 1639208762
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.