Healthcare Provider Details

I. General information

NPI: 1760523864
Provider Name (Legal Business Name): MELISSA L. ESCOBAR M.S. P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

979 EAST AVE
OAKLAND RI
02858-1043
US

IV. Provider business mailing address

979 EAST AVE
OAKLAND RI
02858-1043
US

V. Phone/Fax

Practice location:
  • Phone: 401-371-2890
  • Fax: 401-371-2892
Mailing address:
  • Phone: 401-371-2890
  • Fax: 401-371-2892

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT01789
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: