Provider Demographics
NPI:1790738581
Name:KNECHT, PAUL G (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:G
Last Name:KNECHT
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:CORA - 136 WEST MAIN STREET
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:NEW BRITIAN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-1315
Mailing Address - Country:US
Mailing Address - Phone:860-826-4763
Mailing Address - Fax:860-826-4765
Practice Address - Street 1:CORA - 136 WEST MAIN STREET
Practice Address - Street 2:1ST FLOOR
Practice Address - City:NEW BRITIAN
Practice Address - State:CT
Practice Address - Zip Code:06052-1315
Practice Address - Country:US
Practice Address - Phone:860-826-4763
Practice Address - Fax:860-826-4765
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT002450225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT080002450CT05OtherBC&BS
CT080002450CT05OtherBC&BS