Basic Information
Provider Information
NPI: 1124051255
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KNIGHT
FirstName: CHRISTINE
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 435 HARTFORD TPKE
Address2: SUITE U
City: VERNON
State: CT
PostalCode: 060664852
CountryCode: US
TelephoneNumber: 8609791611
FaxNumber: 2038663014
Practice Location
Address1: 586 MIDDLE TPKE E
Address2:  
City: MANCHESTER
State: CT
PostalCode: 060403730
CountryCode: US
TelephoneNumber: 8606453810
FaxNumber: 8606453814
Other Information
ProviderEnumerationDate: 07/09/2006
LastUpdateDate: 01/28/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X002555CTY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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