MEDICARE: DR. ELIZABETH A ROSVOLD M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	MA068850	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558379602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH A ROSVOLD M.D.

Provider Business Mailing Address
First Line	:	2 CAPITAL WAY
Second Line	:	STE 220
City	:	PENNINGTON
State	:	NJ
Zip	:	08534-2523
Country	:	US
Telephone Number	:	856-829-2340
Fax Number	:

Provider Business Practice Location Address
First Line	:	2079 KLOCKNER RD
Second Line	:
City	:	HAMILTON SQUARE
State	:	NJ
Zip	:	08690-3415
Country	:	US
Telephone Number	:	609-890-1056
Fax Number	:	609-890-7143

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	03/06/2019

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