Individual
NICHOLAS A VITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
123 SUMMER ST STE 521, WORCESTER, MA 01608-1216
(508) 852-0600
(508) 368-3146
Mailing address
123 SUMMER ST STE 521, WORCESTER, MA 01608-1216
(508) 852-0600
(508) 368-3146
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA6556
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11014179A
—
MA
Enumeration date
02/12/2018
Last updated
03/06/2025
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