Provider Demographics
NPI:1760994594
Name:JONUZI, SAM
Entity Type:Individual
Prefix:
First Name:SAM
Middle Name:
Last Name:JONUZI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 A WEST WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08215-2737
Mailing Address - Country:US
Mailing Address - Phone:609-732-0101
Mailing Address - Fax:609-257-6512
Practice Address - Street 1:714 W WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:EGG HARBOR CITY
Practice Address - State:NJ
Practice Address - Zip Code:08215-3838
Practice Address - Country:US
Practice Address - Phone:609-515-1100
Practice Address - Fax:609-257-6512
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist