Provider Demographics
NPI:1679219315
Name:NASTASI, GEMMA (NBCHWC)
Entity Type:Individual
Prefix:
First Name:GEMMA
Middle Name:
Last Name:NASTASI
Suffix:
Gender:F
Credentials:NBCHWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 E BERGEN PL STE 4
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2170
Mailing Address - Country:US
Mailing Address - Phone:732-245-2556
Mailing Address - Fax:
Practice Address - Street 1:227 E BERGEN PL STE 4
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2170
Practice Address - Country:US
Practice Address - Phone:732-245-2556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-06
Last Update Date:2022-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach