Provider Demographics
NPI:1831335900
Name:KNIGHT, ELIZABETH R (PTA)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:R
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5524 HENNESSEY RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12186-5164
Mailing Address - Country:US
Mailing Address - Phone:518-861-5870
Mailing Address - Fax:
Practice Address - Street 1:5524 HENNESSEY RD
Practice Address - Street 2:
Practice Address - City:VOORHEESVILLE
Practice Address - State:NY
Practice Address - Zip Code:12186-5164
Practice Address - Country:US
Practice Address - Phone:518-861-5870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-19
Last Update Date:2008-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001997-1171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor