Basic Information
Provider Information
NPI: 1750309803
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KNIGHT
FirstName: BARBARA
MiddleName: S.
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 615 CHESTNUT ST
Address2: 14TH FLOOR
City: PHILADELPHIA
State: PA
PostalCode: 191064404
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 833 CHESTNUT ST
Address2: SUITE 220
City: PHILADELPHIA
State: PA
PostalCode: 191074414
CountryCode: US
TelephoneNumber: 2159558465
FaxNumber: 2159552516
Other Information
ProviderEnumerationDate: 07/17/2006
LastUpdateDate: 10/31/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD050479LPAY Allopathic & Osteopathic PhysiciansInternal Medicine 

ID Information
IDTypeStateIssuerDescription
771050005NJ MEDICAID
00143084805PA MEDICAID


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