Provider Demographics
NPI:1851470066
Name:KNOLL, BARBARA A (MSCA, CA)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:KNOLL
Suffix:
Gender:F
Credentials:MSCA, CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 GRAND CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:LAVALLETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:08735-2219
Mailing Address - Country:US
Mailing Address - Phone:732-664-2922
Mailing Address - Fax:732-830-8499
Practice Address - Street 1:907 GRAND CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LAVALLETTE
Practice Address - State:NJ
Practice Address - Zip Code:08735-2219
Practice Address - Country:US
Practice Address - Phone:732-664-2922
Practice Address - Fax:732-830-8499
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00021700171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAP1893OtherACUPUNCTURIST
PAAK00575LOtherACUPUNCTURIST
NJ25MZ00021700OtherACUPUNCTURIST