Provider Demographics
NPI:1053594168
Name:GLAUBERMAN-ROCK, CAROL (OTR)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:
Last Name:GLAUBERMAN-ROCK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 MEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-3421
Mailing Address - Country:US
Mailing Address - Phone:617-629-3919
Mailing Address - Fax:617-629-4644
Practice Address - Street 1:61 MEDFORD ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-3421
Practice Address - Country:US
Practice Address - Phone:617-629-3919
Practice Address - Fax:617-629-4644
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA346225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics