Provider Demographics
NPI:1407499882
Name:ZAMORA, JOHNATHAN (NUTRITIONIST)
Entity Type:Individual
Prefix:MR
First Name:JOHNATHAN
Middle Name:
Last Name:ZAMORA
Suffix:
Gender:M
Credentials:NUTRITIONIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 NORDICA DR
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-2818
Mailing Address - Country:US
Mailing Address - Phone:914-844-0361
Mailing Address - Fax:
Practice Address - Street 1:81 NORDICA DR
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-2818
Practice Address - Country:US
Practice Address - Phone:914-844-0361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist