Individual
TENITA C KNOTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3400 CIVIC CENTER BLVD, 2 TRC, PHILADELPHIA, PA 19104
(215) 615-6767
(215) 349-5445
Mailing address
542 E CLARKSON AVE, PHILADELPHIA, PA 19120-2622
(215) 921-1068
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
SP025522
PA
207RN0300X
Nephrology Physician
SP025522
PA
2085R0001X
Radiation Oncology Physician
Primary
SP025522
PA
Other
Enumeration date
07/26/2022
Last updated
08/14/2022
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