Healthcare Provider Details

I. General information

NPI: 1700094729
Provider Name (Legal Business Name): KATHLEEN MARY ZATAVEKAS MBA,RD,LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 5TH AVE SUITE 1-B, ROOM 145-C
PITTSBURGH PA
15213-3403
US

IV. Provider business mailing address

701 DUNCAN AVE APARTMENT 1423
PITTSBURGH PA
15237-5864
US

V. Phone/Fax

Practice location:
  • Phone: 412-647-7999
  • Fax:
Mailing address:
  • Phone: 412-364-2838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN002842
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: