Provider Demographics
NPI:1801812227
Name:MASI, ROBIN M (PA)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:M
Last Name:MASI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:M
Other - Last Name:SIKORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1079 MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-3715
Mailing Address - Country:US
Mailing Address - Phone:401-828-2663
Mailing Address - Fax:401-822-0490
Practice Address - Street 1:1079 MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:WEST WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02893-3715
Practice Address - Country:US
Practice Address - Phone:401-828-2663
Practice Address - Fax:401-822-0490
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA00411363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical