Provider Demographics
NPI:1023743408
Name:ROCKERMANN, BRIANNA (OTR/L)
Entity type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:ROCKERMANN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 RAINIER RD
Mailing Address - Street 2:
Mailing Address - City:FANWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07023-1416
Mailing Address - Country:US
Mailing Address - Phone:845-754-1035
Mailing Address - Fax:
Practice Address - Street 1:16 RAINIER RD
Practice Address - Street 2:
Practice Address - City:FANWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07023-1416
Practice Address - Country:US
Practice Address - Phone:845-754-1035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00780200225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist