Provider Demographics
NPI:1215496856
Name:ROBERMAN-GLYN, JACQUELINE S (OTR/L)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:S
Last Name:ROBERMAN-GLYN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:373 OAK KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3865
Mailing Address - Country:US
Mailing Address - Phone:908-720-7120
Mailing Address - Fax:
Practice Address - Street 1:29 KENTISBURY CIR
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5238
Practice Address - Country:US
Practice Address - Phone:908-720-7120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-13
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist