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General NPI Number Information
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NPI Number | 1255344321
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Entity Type | Individual
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Provider Name | A.E. HERTZLER KNOX MD
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Gender | Male
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | PROHEALTH PHYSICIANS OF BRISTOL 1251 FARMINGTON AVE.
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City | BRISTOL
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State | CT
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Zip | 06010
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Country | US
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Telephone | 860-584-4535
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Fax | 860-589-7656
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Provider Business Mailing Address
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Address Line | PROHEALTH PHYSICIANS OF BRISTOL 1251 FARMINGTON AVE.
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City | BRISTOL
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State | CT
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Zip | 06010
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Country | US
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Telephone | 860-584-4535
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Fax | 860-589-7656
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 029692
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License Number State | CT
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