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General NPI Number Information
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NPI Number | 1083386239
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Entity Type | Individual
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Provider Name | EVA GLIEBERMAN
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Gender | Female
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Dates
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Enumeration Date | 10/05/2021
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Last Update Date | 10/05/2021
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Provider Practice Location Address
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Address Line | 1073 PLEASANT ST
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City | BROCKTON
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State | MA
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Zip | 02301-3039
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Country | US
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Telephone | 508-427-5599
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Fax |
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Provider Business Mailing Address
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Address Line | 9 PUTNAM ST APT 1L
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City | SOMERVILLE
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State | MA
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Zip | 02143-1750
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Country | US
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Telephone | 401-368-5428
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN2335826
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License Number State | MA
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