Provider Demographics
NPI:1093161580
Name:OFFENBERGER, ELISABETH (MS,RD,LDN,CDCES)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:OFFENBERGER
Suffix:
Gender:
Credentials:MS,RD,LDN,CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-341-8250
Mailing Address - Fax:856-341-8251
Practice Address - Street 1:401 YOUNG AVE STE 165
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-3131
Practice Address - Country:US
Practice Address - Phone:856-341-8250
Practice Address - Fax:856-341-8251
Is Sole Proprietor?:No
Enumeration Date:2016-05-13
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4102133V00000X
NJ86026592133V00000X
PADN007606133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered