Provider Demographics
NPI:1093386260
Name:TRATNER, SHIRA D (RDN)
Entity Type:Individual
Prefix:MRS
First Name:SHIRA
Middle Name:D
Last Name:TRATNER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MRS
Other - First Name:SHIRA
Other - Middle Name:D
Other - Last Name:GREENFIELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDN
Mailing Address - Street 1:6416 ELRAY DR APT E
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2934
Mailing Address - Country:US
Mailing Address - Phone:347-668-2487
Mailing Address - Fax:
Practice Address - Street 1:6416 ELRAY DR APT E
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2934
Practice Address - Country:US
Practice Address - Phone:347-668-2487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD86132358133VN1004X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric