Provider Demographics
NPI:1609341650
Name:LAURA ZERVOS FOOD & NUTRITIONAL SERVICES
Entity Type:Organization
Organization Name:LAURA ZERVOS FOOD & NUTRITIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ZERVOS
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LDN
Authorized Official - Phone:412-287-5679
Mailing Address - Street 1:5417 ENTERPRISE BLVD STE 3
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-2691
Mailing Address - Country:US
Mailing Address - Phone:141-228-7567
Mailing Address - Fax:
Practice Address - Street 1:5417 ENTERPRISE BLVD STE 3
Practice Address - Street 2:
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-2691
Practice Address - Country:US
Practice Address - Phone:141-228-7567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty