Individual
JENNY KNAUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1279 E MAIN ST, RIVERHEAD, NY 11901-2583
(631) 727-2100
(631) 727-2646
Mailing address
1279 E MAIN ST, RIVERHEAD, NY 11901-2583
(631) 727-2100
(631) 727-2646
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F301562
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03178883
—
NY
Enumeration date
07/13/2006
Last updated
03/24/2021
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