Provider Demographics
NPI:1952841082
Name:ANSA, KNITTEL (LPO,CPO,BSE)
Entity Type:Individual
Prefix:
First Name:KNITTEL
Middle Name:
Last Name:ANSA
Suffix:
Gender:M
Credentials:LPO,CPO,BSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 GREENBRIAR RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17404-1335
Mailing Address - Country:US
Mailing Address - Phone:717-430-6100
Mailing Address - Fax:717-347-6566
Practice Address - Street 1:506 GREENBRIAR RD
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17404-1335
Practice Address - Country:US
Practice Address - Phone:717-430-6100
Practice Address - Fax:717-347-6566
Is Sole Proprietor?:No
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOH000108222Z00000X
PAPO000218224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist