Provider Demographics
NPI:1851841258
Name:KNOLL, MOLLY MORGAN (PA-C)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:MORGAN
Last Name:KNOLL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:MORGAN
Other - Last Name:FREW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:520 JEFFERSON AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:JEANNETTE
Mailing Address - State:PA
Mailing Address - Zip Code:15644-2538
Mailing Address - Country:US
Mailing Address - Phone:724-527-8060
Mailing Address - Fax:724-522-4002
Practice Address - Street 1:4731 ROUTE 30
Practice Address - Street 2:SUITE 302
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-7260
Practice Address - Country:US
Practice Address - Phone:724-830-9350
Practice Address - Fax:724-830-9353
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA058438363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103208418Medicaid
PA539347Medicare PIN