Provider Demographics
NPI:1093304834
Name:STRANBERG, MATT J (MS RDN LDN CSSD CSCS)
Entity Type:Individual
Prefix:MR
First Name:MATT
Middle Name:J
Last Name:STRANBERG
Suffix:
Gender:M
Credentials:MS RDN LDN CSSD CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 ROSE GARDEN CIR
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-4606
Mailing Address - Country:US
Mailing Address - Phone:978-201-6607
Mailing Address - Fax:
Practice Address - Street 1:9 ROSE GARDEN CIR
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135-4606
Practice Address - Country:US
Practice Address - Phone:978-201-6607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA86042761133VN1501X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports Dietetics