Healthcare Provider Details

I. General information

NPI: 1457623464
Provider Name (Legal Business Name): DOMINIQUE KNIGHT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2012
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 PARK ST STE 3
PEEKSKILL NY
10566-3491
US

IV. Provider business mailing address

121 S HIGHLAND AVE APT 2E
OSSINING NY
10562-5850
US

V. Phone/Fax

Practice location:
  • Phone: 914-497-5537
  • Fax:
Mailing address:
  • Phone: 914-497-5537
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number408033
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: