Provider Demographics
NPI:1124026380
Name:KNECHT, MELISSA LINN (PA-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LINN
Last Name:KNECHT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 N CEDAR CREST BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2351
Mailing Address - Country:US
Mailing Address - Phone:484-884-0617
Mailing Address - Fax:484-884-0628
Practice Address - Street 1:1621 N CEDAR CREST BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-2304
Practice Address - Country:US
Practice Address - Phone:610-402-8900
Practice Address - Fax:610-821-1129
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA030077L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
970010529OtherRAILROAD MEDICARE
1958644OtherHIGHMARK BLUE SHIELD
50044065OtherCAPITAL BLUE CROSS
50044065OtherKEYSTONE HEALTH CENTRAL
329242OtherHEALTHAMERICA/HEALTHASSUR
P3178803OtherOXFORD HEALTH PLANS
970010529OtherRAILROAD MEDICARE
PAS91028Medicare UPIN