Provider Demographics
NPI:1033869250
Name:KNIO, LAILA IMAD (MD)
Entity type:Individual
Prefix:
First Name:LAILA
Middle Name:IMAD
Last Name:KNIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1290 SILAS DEANE HWY
Mailing Address - Street 2:HHC-CVO
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-4337
Mailing Address - Country:US
Mailing Address - Phone:860-972-5507
Mailing Address - Fax:860-972-7040
Practice Address - Street 1:47 LONG LOTS RD
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3828
Practice Address - Country:US
Practice Address - Phone:203-227-1251
Practice Address - Fax:203-226-8616
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT788372084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program