Individual
JESSICA DISTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11 NEVINS ST, SUITE 306, BRIGHTON, MA 02135-3514
(617) 789-2045
Mailing address
11 NEVINS ST, SUITE 306, BRIGHTON, MA 02135-3514
(617) 789-2045
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA5538
MA
363AS0400X
Surgical Physician Assistant
PA5538
MA
Other
Enumeration date
07/10/2013
Last updated
12/12/2025
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