Provider Demographics
NPI:1558751008
Name:KNAUF, CARLA (LMT)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:KNAUF
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 1:335 STATE ROUTE 208
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-2628
Mailing Address - Country:US
Mailing Address - Phone:845-256-0249
Mailing Address - Fax:
Practice Address - Street 1:96 PLAINS RD
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-2732
Practice Address - Country:US
Practice Address - Phone:845-255-2188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010233-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist