Doctor Name: | SOPHIA ZIGOURAS |
NPI Number: | 1316369440 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., R.D., C.N.S.C. |
License Number: | |
Business Practice Address: | 83 Walnut Dr Tenafly, NJ - 076702837 |
Business Phone Number: | 2018195958 |
Business Fax Number: | |
Mailing Address: | 83 Walnut Dr, TENAFLY |
State: | NJ |
Postal Code: | 076702837 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/08/2014 |
NPI Last Update Date: | 04/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133VN1004X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | Nutrition, Pediatric |
Taxonomy Definition: |