Xynellis, Jason Charles

Xynellis, Jason Charles is an individual health care provider with primary practice located at 1195 N Main St , Providence RI 02904-1824. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Xynellis, Jason Charles can be contacted via phone (401) 331-8555.

Contact Information

Primary practice address
1195 N Main St Providence RI 02904-1824
Phone: (401) 331-8555
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA00501 Rhode Island

Profile Details

NPI number 1952501942
LBN Legal business name Xynellis, Jason Charles
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2007
Last updated Nov 30th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952501942 NPPES
Rhode Island Other 0021338 MEDICARE PTAN
Rhode Island MEDICAID JX84601 MEDICARE PTAN

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