Provider Demographics
NPI:1326660820
Name:ROCKERMANN, ASHLEY (LMT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:ROCKERMANN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 WILLOW TREE RD APT 1
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:NY
Mailing Address - Zip Code:12547-5303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 HURLEY AVE
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-2800
Practice Address - Country:US
Practice Address - Phone:845-905-9111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026176225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist