Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 228132 | NY |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 25MA08204800 | NJ |
NPI | 1063612596 |
---|---|
Provider Name | Colette Monique Knight |
First Address | Hackensack, NJ 07601-2206 |
Second Address | Hackensack, NJ 07601-2206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2007 |
Last Update Date | 12/07/2019 |