Provider Demographics
NPI:1023744737
Name:KNOTTS, TENITA C (NP)
Entity type:Individual
Prefix:
First Name:TENITA
Middle Name:C
Last Name:KNOTTS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:542 E CLARKSON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-2622
Mailing Address - Country:US
Mailing Address - Phone:215-921-1068
Mailing Address - Fax:
Practice Address - Street 1:3400 CIVIC CENTER BLVD
Practice Address - Street 2:2 TRC
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104
Practice Address - Country:US
Practice Address - Phone:215-615-6767
Practice Address - Fax:215-349-5445
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-08-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PASP025522207RN0300X, 2085R0001X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine