Provider Demographics
NPI:1700094729
Name:ZATAVEKAS, KATHLEEN MARY (MBA,RD,LDN)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MARY
Last Name:ZATAVEKAS
Suffix:
Gender:F
Credentials:MBA,RD,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 DUNCAN AVE
Mailing Address - Street 2:APARTMENT 1423
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15237-5864
Mailing Address - Country:US
Mailing Address - Phone:412-364-2838
Mailing Address - Fax:
Practice Address - Street 1:3601 5TH AVE
Practice Address - Street 2:SUITE 1-B, ROOM 145-C
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-3403
Practice Address - Country:US
Practice Address - Phone:412-647-7999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN002842133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION59170005Medicare ID - Type UnspecifiedALSO IN PA