Individual
MR. ROCK M OLOFERNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
148 SAFRAN AVE, EDISON, NJ 08837
(732) 983-2633
Mailing address
148 SAFRAN AVE, EDISON, NJ 08837
(732) 983-2633
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00432700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
O55126617401782
DRIVERS LICENSE
NJ
Enumeration date
09/13/2012
Last updated
09/13/2012
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