Provider Demographics
NPI:1558021329
Name:BARMATZ, ELAD N/A (RDN,MPH,MS)
Entity Type:Individual
Prefix:
First Name:ELAD
Middle Name:N/A
Last Name:BARMATZ
Suffix:
Gender:M
Credentials:RDN,MPH,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3306 DEVONSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-3807
Mailing Address - Country:US
Mailing Address - Phone:347-334-2424
Mailing Address - Fax:
Practice Address - Street 1:3306 DEVONSHIRE DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-3807
Practice Address - Country:US
Practice Address - Phone:347-334-2424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-21
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Multi-Specialty