Provider Demographics
NPI:1699338103
Name:ZACHMANN, THOMAS (RD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:ZACHMANN
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 WALTER CT
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3602
Mailing Address - Country:US
Mailing Address - Phone:516-502-5577
Mailing Address - Fax:833-734-1553
Practice Address - Street 1:400 S OYSTER BAY RD STE 300
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3500
Practice Address - Country:US
Practice Address - Phone:516-502-5577
Practice Address - Fax:833-734-1553
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009640-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered