Basic Information
| Provider Information | |||||||||
| NPI: | 1528076445 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBILLARD | ||||||||
| FirstName: | MARTHA | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | OTRL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 630 PLANTATION ST | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9788401900 | ||||||||
| FaxNumber: | 9788401263 | ||||||||
| Practice Location | |||||||||
| Address1: | 165 MILL ST | ||||||||
| Address2: | |||||||||
| City: | LEOMINSTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01453 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9788401900 | ||||||||
| FaxNumber: | 5088401263 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2006 | ||||||||
| LastUpdateDate: | 02/24/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 3267 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
ID Information
| ID | Type | State | Issuer | Description | 7600617 | 01 | AETNA | OTHER | OT0066 | 01 | BLUE CROSS | OTHER | 7600617 | 01 | US HEALTHCARE | OTHER | 042472266 | 01 | ONE HEALTH PLAN | OTHER | 43215 | 01 | FALLON COMM HEALTH PLAN | OTHER | 042472266 | 01 | CHAMPUS | OTHER | 0701203 | 01 | WELFARE | OTHER | 2779432 | 01 | CIGNA HEALTH PLAN | OTHER | 785963 | 01 | MVP HEALTH CARE | OTHER | 042472266 | 01 | HEALTHCARE VALUE MGMT | OTHER | 042472266 | 01 | PRIVATE HEALTHCARE SYSTEM | OTHER | 042472266 | 01 | THREE RIVERS | OTHER | 0701203 | 05 | MA | MEDICAID | 670001295 | 01 | RAILROAD MEDICARE | OTHER | 042472266 | 01 | TRICARE | OTHER | Y68481 | 01 | MEDICARE B | OTHER |