Healthcare Provider Details

I. General information

NPI: 1558021329
Provider Name (Legal Business Name): ELAD N/A BARMATZ RDN,MPH,M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2021
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3306 DEVONSHIRE DR
BALTIMORE MD
21215-3807
US

IV. Provider business mailing address

3306 DEVONSHIRE DR
BALTIMORE MD
21215-3807
US

V. Phone/Fax

Practice location:
  • Phone: 347-334-2424
  • Fax:
Mailing address:
  • Phone: 347-334-2424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDX6051
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: