Mary Ellen Distasio

NPI 1659563179 - Student in an Organized Health Care Education/Training Program - 390200000X

NPI Details
NPI 1659563179
Gender Female
Enumeration Date 08/17/2007
Last Updated 09/15/2014
Entity Type Individual
Active Over 10 years ago
Practice Location
50 REDFIELD ST
SUITE 300
DORCHESTER MA, 02122-3630, US
Phone (617) 467-8176
Fax
Business Location
50 REDFIELD ST
SUITE 300
DORCHESTER MA, 02122-3630, US
Phone
Fax
Toxanomy
Taxonomy Code 390200000X
License State
License Number
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According to our database, Mrs. Mary Ellen Distasio NPI is 1659563179, taxonomy code is 390200000X Mary Ellen Distasio physically located at 50 Redfield St, Dorchester MA, 02122-3630. NPI Number Mary Ellen Distasio has the Individual type.

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1659563179 NPI number is provided on an as is basis without warranty of any kind. 1659563179 is maintained by the National Plan & Provider Enumeration System. The contents of Mary Ellen Distasio are for informational purposes only.