Provider Demographics
NPI:1871639765
Name:MARGO KNAPP MD
Entity Type:Organization
Organization Name:MARGO KNAPP MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARGO
Authorized Official - Middle Name:
Authorized Official - Last Name:KNAPP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-764-2501
Mailing Address - Street 1:PO BOX 1434
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446
Mailing Address - Country:US
Mailing Address - Phone:781-764-2501
Mailing Address - Fax:
Practice Address - Street 1:82 MARLBOROUGH ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116
Practice Address - Country:US
Practice Address - Phone:781-764-2501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA721032084P0800X, 2084P0804X
TXF68312084P0800X, 2084P0804X
CAC416162084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3033457Medicaid
MA7527197OtherAETNA
MAJ07298Medicare ID - Type Unspecified
B74982Medicare UPIN