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General NPI Number Information
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NPI Number | 1760929905
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Entity Type | Individual
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Provider Name | LARA ZAKARIA RPH MS CNS
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Gender | Female
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Dates
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Enumeration Date | 01/26/2017
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Last Update Date | 01/26/2017
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Provider Practice Location Address
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Address Line | 611 W163RD ST #24
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City | NEW YORK
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State | NY
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Zip | 10032
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Country | US
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Telephone | 929-354-3236
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Fax |
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Provider Business Mailing Address
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Address Line | 11 JOHN ST # 1622
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City | NEW YORK
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State | NY
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Zip | 10038-4027
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 001463
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License Number State | CT
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