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General NPI Number Information
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NPI Number | 1093666711
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Entity Type | Organization
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Legal Business Name | AVA HEALTH LLC
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Dates
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Enumeration Date | 02/07/2026
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Last Update Date | 02/15/2026
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Provider Practice Location Address
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Address Line | 2109 HARTFORD AVE
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City | JOHNSTON
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State | RI
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Zip | 02919-3246
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Country | US
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Telephone | 401-587-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 73 SOWAMS RD
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City | BARRINGTON
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State | RI
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Zip | 02806-4602
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | DR. BRIAN MIKOLASKO
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Credential | MD, MBA, MS
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Telephone | 626-319-5932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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