Provider Demographics
NPI:1134288525
Name:BERZAI, ANNA C (RD)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:C
Last Name:BERZAI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6016 SUTTON PL
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46614-6136
Mailing Address - Country:US
Mailing Address - Phone:574-286-8507
Mailing Address - Fax:
Practice Address - Street 1:6016 SUTTON PL
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614-6136
Practice Address - Country:US
Practice Address - Phone:574-286-8507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN976983133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN976983OtherLICENSE NUMBER
IN37001740AOtherINDIANA CERTIFICATION #