Provider Demographics
NPI:1285673640
Name:KROLICK, BARBARA E (RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:E
Last Name:KROLICK
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BLOODY BROOK DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH DEERFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01373-1154
Mailing Address - Country:US
Mailing Address - Phone:413-665-7107
Mailing Address - Fax:
Practice Address - Street 1:53A S MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH DEERFIELD
Practice Address - State:MA
Practice Address - Zip Code:01373-1027
Practice Address - Country:US
Practice Address - Phone:413-665-9920
Practice Address - Fax:413-397-8899
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2017-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA869133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP00130878OtherRAILROAD MEDICARE
MA29365OtherHEALTH NEW ENGLAND
MALD 0041OtherBLUE CROSS/ BLUE SHIELD
MA000000022705OtherBMC HEALTH PLAN
MA39456OtherHARVARD PILGRIM
MA403912OtherTUFTS HEALTH PLAN
MALD 0041OtherBLUE CROSS/ BLUE SHIELD