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NPI Code Detail

MEDICARE: ALIAZAY KNIGHT

MEDICARE:   ALIAZAY  KNIGHT
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
1171400000XHealth & Wellness Coach
2172V00000XCommunity Health Worker
3174H00000XHealth Educator
4174V00000XClinical Ethicist
5171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1457007627
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALIAZAY KNIGHT
Provider Business Mailing Address
First Line : 3007 W SAINT PAUL AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53208-4215
Country : US
Telephone Number : 702-845-2262
Fax Number :
Provider Business Practice Location Address
First Line : 3007 W SAINT PAUL AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53208-4215
Country : US
Telephone Number : 702-845-2262
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2022
Last Update Date : 02/26/2022

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