MEDICARE: DR. EDMOND ALAN KNOPP 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	2085R0202X	Diagnostic Radiology Physician	172598	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588628861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDMOND ALAN KNOPP M.D.

Provider Business Mailing Address
First Line	:	79 BROOK HILLS CIR
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-5021
Country	:	US
Telephone Number	:	914-725-1099
Fax Number	:

Provider Business Practice Location Address
First Line	:	79 BROOK HILLS CIR
Second Line	:
City	:	WHITE PLAINS
State	:	NY
Zip	:	10605-5021
Country	:	US
Telephone Number	:	914-725-1099
Fax Number	:

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

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	12/26/2024

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