Provider Demographics
NPI:1942620943
Name:PLATT, ZACHARY (CNP)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:PLATT
Suffix:
Gender:M
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10400 CONNECTICUT AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-3910
Mailing Address - Country:US
Mailing Address - Phone:301-942-7979
Mailing Address - Fax:
Practice Address - Street 1:10400 CONNECTICUT AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-3910
Practice Address - Country:US
Practice Address - Phone:301-942-7979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZC796133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist