Provider Demographics
NPI:1457388845
Name:ROSENCRANS, BARRIE K (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:BARRIE
Middle Name:K
Last Name:ROSENCRANS
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 AURORA HUDSON RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OH
Mailing Address - Zip Code:44202-7512
Mailing Address - Country:US
Mailing Address - Phone:330-618-0999
Mailing Address - Fax:
Practice Address - Street 1:3619 PARK EAST DR
Practice Address - Street 2:SUITE 110
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-4330
Practice Address - Country:US
Practice Address - Phone:216-464-4646
Practice Address - Fax:216-464-4695
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD 3903133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered