Healthcare Provider Details

I. General information

NPI: 1659023158
Provider Name (Legal Business Name): TAYLOR ZUK MS, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2022
Last Update Date: 03/20/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 SOUTH ST # 132
PHILADELPHIA PA
19147-2023
US

IV. Provider business mailing address

553 HARLEYSVILLE PIKE
SOUDERTON PA
18964-1634
US

V. Phone/Fax

Practice location:
  • Phone: 215-867-9424
  • Fax:
Mailing address:
  • Phone: 215-237-3896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN006077
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: