Provider Demographics
NPI:1083814289
Name:SIMZAK, SONJA C (MS-MPH, RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:SONJA
Middle Name:C
Last Name:SIMZAK
Suffix:
Gender:F
Credentials:MS-MPH, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 ARMY PENTAGON
Mailing Address - Street 2:DILORENZO TRICARE HEALTH CLINIC
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20310-5801
Mailing Address - Country:US
Mailing Address - Phone:703-692-8898
Mailing Address - Fax:
Practice Address - Street 1:5801 ARMY PENTAGON
Practice Address - Street 2:DILORENZO PENTAGON HEALTH CLINIC
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20310
Practice Address - Country:US
Practice Address - Phone:036-927-8898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX2932133N00000X
MD978644133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist