Individual
MICHAEL WASSIM NICOLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 643-2275
(617) 726-3306
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2696
(617) 643-2275
(617) 726-3306
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2319976
MA
Other
Enumeration date
05/07/2026
Last updated
05/07/2026
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