Provider Demographics
NPI:1578611919
Name:MCKNIGHT, JOHN MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MICHAEL
Last Name:MCKNIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:57 W 57TH ST STE 1410
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2813
Mailing Address - Country:US
Mailing Address - Phone:917-672-1988
Mailing Address - Fax:212-713-1631
Practice Address - Street 1:57 W 57TH ST STE 1410
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2813
Practice Address - Country:US
Practice Address - Phone:917-672-1988
Practice Address - Fax:917-900-1343
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226815207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY133010833OtherPHCS
NY021SK1OtherEMPIRE BC BS
NY133010833OtherAETNA
NY2298798OtherUNITED HEALTH CARE
NY7365531OtherCIGNA
NYP2831883OtherOXFORD
NY187112POtherHIP
NY133010833Other1199
NYMJ6815OtherATLANTIS
NY021SK1OtherEMPIRE BC BS