Provider Demographics
NPI:1255474086
Name:ZOHMAN, LAURA (LDN)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:ZOHMAN
Suffix:
Gender:F
Credentials:LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 35
Mailing Address - Street 2:
Mailing Address - City:TOPSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01983-0035
Mailing Address - Country:US
Mailing Address - Phone:978-777-9911
Mailing Address - Fax:
Practice Address - Street 1:194 NORTH ST
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-1242
Practice Address - Country:US
Practice Address - Phone:978-777-9911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1912133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALD0005OtherBLUE CROSS BLUE SHIELD
MALD0005OtherBLUE CROSS BLUE SHIELD