Provider Demographics
NPI:1235728635
Name:MULZAC, SHARON PATRICIA (MS, RD, CDN)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:PATRICIA
Last Name:MULZAC
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2027 STANLEY TER
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-4029
Mailing Address - Country:US
Mailing Address - Phone:908-986-7303
Mailing Address - Fax:
Practice Address - Street 1:2027 STANLEY TER
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-4029
Practice Address - Country:US
Practice Address - Phone:908-986-7303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1003689133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management