# DR. NICOLE MASTANDO

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1871574392
- **Gender:** F
- **Credential:** DC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 2790 | MA | Yes |

## Other

- **Enumeration date:** 11/10/2005
- **Last updated:** 09/15/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1101391 | AETNA | MA |
| 05 | — | 1600681 | — | MA |
| 01 | — | AA46029 | HARVARD PILGRIM | MA |
| 01 | — | Y37029 | BCBS OF MA | MA |