Jake T Broccolo, DPT

NPI #1144709114 in North Providence, Rhode Island

Provider Information

NPI Number: 1144709114
Entity Type: Individual
Name: Jake T Broccolo, DPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: DPT
Enumeration Date: Aug 10, 2018
Last Updated: Jan 30, 2026

Practice Location

Address: 1401 DOUGLAS AVE
City: North Providence
State: Rhode Island
ZIP Code: 02904-4058
Phone: (401) 726-7100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

Additional Practice Locations

1295 Fall River Ave

Seekonk, MA, 02771-5931

(508) 231-5944

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