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General NPI Number Information
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NPI Number | 1447771282
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Entity Type | Individual
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Provider Name | THOMAS JOSEPH KNIGHTLY JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/01/2017
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 1055 SUMMER ST STE 2
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City | STAMFORD
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State | CT
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Zip | 06905-5527
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Country | US
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Telephone | 203-504-9758
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Fax |
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Provider Business Mailing Address
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Address Line | 1055 SUMMER ST STE 2
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City | STAMFORD
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State | CT
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Zip | 06905-5527
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Country | US
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Telephone | 203-504-9758
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Fax | 203-547-4914
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A171719
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 71157
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License Number State | CT
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