Individual
NICOLE GRACE MISTRETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
336 HUNTINGTON AVE, BOSTON, MA 02115
(617) 373-3195
Mailing address
136 HAMILTON ST, SAUGUS, MA 01906-1531
(617) 957-9177
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA8430
—
390200000X
Student in an Organized Health Care Education/Training Program
—
MA
Other
Enumeration date
09/25/2020
Last updated
06/03/2025
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