Healthcare Provider Details

I. General information

NPI: 1831010982
Provider Name (Legal Business Name): NICHOLAS JOHN JASIEL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

746 BLISS RD
LONGMEADOW MA
01106-1557
US

IV. Provider business mailing address

18 KAZBECK ST
SPRINGFIELD MA
01151-2114
US

V. Phone/Fax

Practice location:
  • Phone: 413-567-8961
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH1003851
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: