Healthcare Provider Details

I. General information

NPI: 1275744419
Provider Name (Legal Business Name): ANNE MARIE ROBINSON GLASSCOCK OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 DUNNING RD
MIDDLETOWN NY
10940-2243
US

IV. Provider business mailing address

32 WEDGEWOOD LN
MIDDLETOWN NY
10940-7218
US

V. Phone/Fax

Practice location:
  • Phone: 845-343-0801
  • Fax:
Mailing address:
  • Phone: 845-386-4505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number003785
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: