Provider Demographics
NPI:1568976330
Name:ELLIOTT, ROSALIND C (CNM)
Entity type:Individual
Prefix:
First Name:ROSALIND
Middle Name:C
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WYCKOFF RD STE 4600
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-0200
Mailing Address - Country:US
Mailing Address - Phone:862-781-3877
Mailing Address - Fax:
Practice Address - Street 1:200 WYCKOFF RD STE 4600
Practice Address - Street 2:
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724-0200
Practice Address - Country:US
Practice Address - Phone:862-781-3877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-30
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201709638NP-PP367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife