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NPI Code Detail

MEDICARE: MRS. BARBARA E. KROLICK RD, LDN

MEDICARE:  MRS. BARBARA E. KROLICK  RD, LDN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian869MA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00130878OTHERMARAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
229365OTHERMAHEALTH NEW ENGLAND
3LD 0041OTHERMABLUE CROSS/ BLUE SHIELD
4000000022705OTHERMABMC HEALTH PLAN
539456OTHERMAHARVARD PILGRIM
6403912OTHERMATUFTS HEALTH PLAN

General Provider Information

NPI Number : 1285673640
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BARBARA E. KROLICK RD, LDN
Provider Business Mailing Address
First Line : 4 BLOODY BROOK DR
Second Line :
City : SOUTH DEERFIELD
State : MA
Zip : 01373-1154
Country : US
Telephone Number : 413-665-7107
Fax Number :
Provider Business Practice Location Address
First Line : 53A S MAIN ST
Second Line :
City : SOUTH DEERFIELD
State : MA
Zip : 01373-1027
Country : US
Telephone Number : 413-665-9920
Fax Number : 413-397-8899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2006
Last Update Date : 09/25/2017

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Directions to “ MRS. BARBARA E. KROLICK RD, LDN” Practice Location

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