MEDICARE: JONATHAN M KNEE DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	N0053351	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427049535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN M KNEE DPM

Provider Business Mailing Address
First Line	:	514 GRAMATAN AVE
Second Line	:	P4
City	:	MOUNT VERNON
State	:	NY
Zip	:	10552-3054
Country	:	US
Telephone Number	:	914-667-2225
Fax Number	:	914-667-2224

Provider Business Practice Location Address
First Line	:	514 GRAMATAN AVE
Second Line	:	P4
City	:	MOUNT VERNON
State	:	NY
Zip	:	10552-3054
Country	:	US
Telephone Number	:	914-667-2225
Fax Number	:	914-667-2224

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	10/15/2009

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