Provider Demographics
NPI:1982657508
Name:ROCHELEAU, KARLA (PT)
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:
Last Name:ROCHELEAU
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 WASHINGTON ST
Mailing Address - Street 2:STE 200
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-5709
Mailing Address - Country:US
Mailing Address - Phone:774-696-8309
Mailing Address - Fax:508-297-8416
Practice Address - Street 1:33 ELECTRIC AVENUE
Practice Address - Street 2:STE B10
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420
Practice Address - Country:US
Practice Address - Phone:978-353-0030
Practice Address - Fax:978-353-0059
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7378225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY66961OtherBCBS
MA468149OtherTUFTS
CA1195Medicare PIN