Individual
DENISE BARRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
26 CITY HALL MALL, MEDFORD, MA 02155-4754
(617) 629-6444
Mailing address
147 MILK ST, PROVIDER ENROLLMENT 9TH FLOOR, BOSTON, MA 02109-4806
(617) 559-8051
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
549
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015211
NEIGHBORHOOD HEALTH PLAN
MA
01
—
680078
TUFTS HEALTH PLAN
MA
01
—
AA36166
HARVARD PILGRIM
MA
01
—
LD0030
BLUE CROSS
MA
Enumeration date
01/26/2006
Last updated
04/07/2009
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