1710584701 NPI number — ELIZABETH ANN BARTH MS, RD, LDN

Table of content: ELIZABETH ANN BARTH MS, RD, LDN (NPI 1710584701)

General
Organization/Personal Information
Provider's Other Name Information
NPI Number Information
Provider's Business Mailing Address
Provider's Practice Location Mailing Address
Additional Information
Authorized Official
Provider Taxonomy Codes
Other Provider's Identifiers (legacy, non-NPI)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710584701 NPI number — ELIZABETH ANN BARTH MS, RD, LDN

Organization/Personal Information

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:
BARTH

Provider First Name:
ELIZABETH

Provider Middle Name:
ANN

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:
MS, RD, LDN

Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710584701

Entity Type Code:
Individual

Replacement NPI:

Last Update Date:
12/10/2025

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
867 BOYLSTON ST STE 500

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:
BOSTON

Provider Business Mailing Address State Name:
MA

Provider Business Mailing Address Postal Code:
02116-2774

Provider Business Mailing Address Country Code:
US

Provider Business Mailing Address Telephone Number:
857-452-1364

Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARRERA 2B OESTE NO 15-15

Provider Second Line Business Practice Location Address:
TORRES DEL BOSQUE APTO S03-A

Provider Business Practice Location Address City Name:
CALI

Provider Business Practice Location Address State Name:
VALLE DEL CAUCA

Provider Business Practice Location Address Postal Code:
760045

Provider Business Practice Location Address Country Code:
CO

Provider Business Practice Location Address Telephone Number:

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:
10/03/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

Provider Taxonomy Codes

Taxonomy code: 133V00000X , with the licence number: 4628 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .