Provider Demographics
NPI:1164548061
Name:PAIZ, SONYA M (RD, LD)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:M
Last Name:PAIZ
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:SONYA
Other - Middle Name:A
Other - Last Name:MELWANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD
Mailing Address - Street 1:11705 MOCHO PL NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87123-1334
Mailing Address - Country:US
Mailing Address - Phone:505-332-8070
Mailing Address - Fax:505-275-6678
Practice Address - Street 1:11705 MOCHO PL NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-1334
Practice Address - Country:US
Practice Address - Phone:505-332-8070
Practice Address - Fax:505-275-6678
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMLD0582133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM83429263Medicaid