Provider Demographics
NPI:1417496084
Name:ZATCOFF, GERALDINE (MS, MSED, CNS)
Entity type:Individual
Prefix:MISS
First Name:GERALDINE
Middle Name:
Last Name:ZATCOFF
Suffix:
Gender:F
Credentials:MS, MSED, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1391 MADISON CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29466-7961
Mailing Address - Country:US
Mailing Address - Phone:203-913-1338
Mailing Address - Fax:
Practice Address - Street 1:1391 MADISON CT
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29466-7961
Practice Address - Country:US
Practice Address - Phone:203-913-1338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCNS10129133N00000X, 133NN1002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education