Provider Demographics
NPI:1811881774
Name:SUBACIUTE, NASTIA
Entity type:Individual
Prefix:
First Name:NASTIA
Middle Name:
Last Name:SUBACIUTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 REEDY MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:GROTON
Mailing Address - State:MA
Mailing Address - Zip Code:01450-1011
Mailing Address - Country:US
Mailing Address - Phone:978-727-7234
Mailing Address - Fax:
Practice Address - Street 1:19 FOSTER ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-1715
Practice Address - Country:US
Practice Address - Phone:508-373-5607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant