Provider Demographics
NPI:1811089576
Name:NASTASIA, GERALD JR (DC)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:
Last Name:NASTASIA
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 JEAN DR
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:NH
Mailing Address - Zip Code:03874-4196
Mailing Address - Country:US
Mailing Address - Phone:781-888-2419
Mailing Address - Fax:
Practice Address - Street 1:70 NEW OCEAN ST
Practice Address - Street 2:
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907-1831
Practice Address - Country:US
Practice Address - Phone:781-581-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1524111NX0800X
MO2006022689111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA737865OtherTUFTS
MA508030OtherHCVM
MAB20294501OtherCIGNA
MAY36064OtherBLUECROSS OF MA
MA998114OtherNETWORK HEALTH
MA01539OtherAETNA US HEALTHCARE
MAY36064OtherBLUECROSS OF MA
MAB20294501OtherCIGNA