Provider Demographics
NPI:1316737646
Name:ROCKWELL, ELIZABETH (LICENSED)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:ROCKWELL
Suffix:
Gender:
Credentials:LICENSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 AMICALOLA DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07422-1426
Mailing Address - Country:US
Mailing Address - Phone:201-248-5249
Mailing Address - Fax:
Practice Address - Street 1:2 AMICALOLA DR
Practice Address - Street 2:
Practice Address - City:HIGHLAND LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07422-1426
Practice Address - Country:US
Practice Address - Phone:201-248-5249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ13VH09357200171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications