MICHAEL DISTASIO

Individual Provider (NPI-1) Active

Nurse Practitioner, Family

Provider Information

Registered Nurse, Critical Care Medicine License: CT #154019

Nurse Practitioner, Family Primary License: CT #14094

LOCATION

YALE NEW HAVEN HEALTH 789 HOWARD AVENUE

NEW HAVEN, CT, 06460

MAILING

69 CARRIAGE PATH S

MILFORD, CT, 064607544