Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 147484 | NY |
NPI | 1013953843 |
---|---|
Provider Name | Reginald Quentin Knight |
First Address | Cooperstown, NY 13326-0725 |
Second Address | Cooperstown, NY 13326-1301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 15/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A64304 | (02) |