Healthcare Provider Details

I. General information

NPI: 1427678986
Provider Name (Legal Business Name): BLAYNE ANNE KNAPP DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CLARA BARTON DR
ALBANY NY
12208-3472
US

IV. Provider business mailing address

2 CLARA BARTON DR
ALBANY NY
12208-3472
US

V. Phone/Fax

Practice location:
  • Phone: 518-262-5196
  • Fax:
Mailing address:
  • Phone: 518-262-5196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number338128
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number338128
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: