Individual
MR. SHANNON B KNAGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1450 CHAPEL STREET, NEW HAVEN, CT 06511
(203) 789-4074
(203) 867-5534
Mailing address
PO BOX 1951, SAINT RAPHAEL PHYSICIANS, BRATTLEBORO, VT 05302-1951
(508) 595-0531
(508) 829-5367
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
001902
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004193116
—
CT
Enumeration date
07/24/2006
Last updated
09/18/2008
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