Doctor Name: | DR. JENNIFER AW KNUTSEN |
NPI Number: | 1114993292 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | MD425742 |
Business Practice Address: | 5100 W. Toft Rd Ste. 2a Liverpool, NY - 130883807 |
Business Phone Number: | 4126473553 |
Business Fax Number: | |
Mailing Address: | 4567 Crossroads Park Dr, LIVERPOOL |
State: | NY |
Postal Code: | 130883589 |
Phone Number: | 3152952100 |
Fax Number: | 3152952125 |
NPI Enumeration Date: | 02/27/2006 |
NPI Last Update Date: | 01/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD425742 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |