Individual
NICHOLAS DISTASIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
40 HOLLAND ST, SOMERVILLE, MA 02144-2705
(339) 222-2235
Mailing address
14 WILDWOOD AVE, ARLINGTON, MA 02476-6422
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
RN2359368
MA
Other
Enumeration date
03/30/2026
Last updated
03/30/2026
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