Provider Demographics
NPI:1801350681
Name:ZAKI, SARA DAWN CHANDON (MS, RDN, RYT)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:DAWN CHANDON
Last Name:ZAKI
Suffix:
Gender:F
Credentials:MS, RDN, RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MECHANIC ST STE 150
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1858
Mailing Address - Country:US
Mailing Address - Phone:908-376-6614
Mailing Address - Fax:732-345-7348
Practice Address - Street 1:10 MECHANIC STREET SUITE 150
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1858
Practice Address - Country:US
Practice Address - Phone:908-376-6614
Practice Address - Fax:732-345-7348
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1043531133NN1002X, 133N00000X, 133V00000X, 133VN1006X, 133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic