Provider Demographics
NPI:1780969899
Name:ZONCA, ANN KRYSTYN (MS,RD,CDN,LDN)
Entity type:Individual
Prefix:MS
First Name:ANN
Middle Name:KRYSTYN
Last Name:ZONCA
Suffix:
Gender:F
Credentials:MS,RD,CDN,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 W 56TH ST
Mailing Address - Street 2:APT #3C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3607
Mailing Address - Country:US
Mailing Address - Phone:773-294-7133
Mailing Address - Fax:856-344-1438
Practice Address - Street 1:421 W 56TH ST
Practice Address - Street 2:APT #3C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3607
Practice Address - Country:US
Practice Address - Phone:773-294-7133
Practice Address - Fax:856-344-1438
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY881783133V00000X
IL164005280133V00000X
NY006946133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered