Healthcare Provider Details

I. General information

NPI: 1093161580
Provider Name (Legal Business Name): ELISABETH OFFENBERGER MS,RD,LDN,CDCES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2016
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 YOUNG AVE STE 165
MOORESTOWN NJ
08057-3131
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-341-8250
  • Fax: 856-341-8251
Mailing address:
  • Phone: 856-341-8250
  • Fax: 856-341-8251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number4102
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86026592
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN007606
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: