Provider Demographics
NPI:1730458746
Name:KNIGHT COMPREHENSIVE PHYSICAL THERAPY
Entity Type:Organization
Organization Name:KNIGHT COMPREHENSIVE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:L
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:973-636-2732
Mailing Address - Street 1:246 HAMBURG TPKE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2156
Mailing Address - Country:US
Mailing Address - Phone:973-636-2732
Mailing Address - Fax:973-636-2734
Practice Address - Street 1:246 HAMBURG TPKE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2156
Practice Address - Country:US
Practice Address - Phone:973-636-2732
Practice Address - Fax:973-636-2734
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-20
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00920400225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty