Healthcare Provider Details

I. General information

NPI: 1093362964
Provider Name (Legal Business Name): KRISTINA KNEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2019
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2049 GEORGE URBAN BLVD
DEPEW NY
14043-1823
US

IV. Provider business mailing address

11 LEONARD DR
DEPEW NY
14043-2558
US

V. Phone/Fax

Practice location:
  • Phone: 716-901-8700
  • Fax:
Mailing address:
  • Phone: 315-708-5999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number102135-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: