Provider Demographics
NPI:1245563980
Name:KNIGHT, GRACE ANNETTA (O T R)
Entity Type:Individual
Prefix:MS
First Name:GRACE
Middle Name:ANNETTA
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:O T R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:8234 167TH ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-1222
Mailing Address - Country:US
Mailing Address - Phone:718-926-0236
Mailing Address - Fax:718-969-3063
Practice Address - Street 1:1200 WATERS PLACE
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-0000
Practice Address - Country:US
Practice Address - Phone:718-536-3251
Practice Address - Fax:718-536-3240
Is Sole Proprietor?:No
Enumeration Date:2009-09-14
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006580-1225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist