MEDICARE: DR. ANTHONY FREDERICK KNOTT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	232102	NY

General Provider Information

NPI Number	:	1164419529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY FREDERICK KNOTT M.D.

Provider Business Mailing Address
First Line	:	73 JOHN DRIVE
Second Line	:	UPSTAIRS
City	:	FARMINGVILLE
State	:	NY
Zip	:	11738-1958
Country	:	US
Telephone Number	:	631-320-0859
Fax Number	:

Provider Business Practice Location Address
First Line	:	73 JOHN DRIVE
Second Line	:	UPSTAIRS
City	:	FARMINGVILLE
State	:	NY
Zip	:	11738-1958
Country	:	US
Telephone Number	:	631-320-0859
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	08/07/2019

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