Provider Demographics
NPI:1114477593
Name:MUNOZ, JULIA SHOOK (RD)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:SHOOK
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 TOLL HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-1032
Mailing Address - Country:US
Mailing Address - Phone:203-361-8855
Mailing Address - Fax:
Practice Address - Street 1:491 TOLL HOUSE LN
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-1032
Practice Address - Country:US
Practice Address - Phone:203-361-8855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-10
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT86017601133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTC02658OtherMEDICARE YNHH MEDICARE NUMBER