Provider Demographics
NPI:1083156392
Name:ZANGWILL, JONATHAN (RD, LDN)
Entity Type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:
Last Name:ZANGWILL
Suffix:
Gender:M
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 WASHINGTON ST
Mailing Address - Street 2:APARTMENT 4C
Mailing Address - City:STOUGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02072-4227
Mailing Address - Country:US
Mailing Address - Phone:609-947-2900
Mailing Address - Fax:
Practice Address - Street 1:680 CENTRE ST
Practice Address - Street 2:SIGNATURE HEALTHCARE BROCKTON HOSPITAL - FOOD/NUTRITION
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02302-3308
Practice Address - Country:US
Practice Address - Phone:508-941-7433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4045133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered