Provider Demographics
NPI:1144291972
Name:KNOEPFLMACHER, PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:KNOEPFLMACHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 LEXINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6103
Mailing Address - Country:US
Mailing Address - Phone:646-745-2888
Mailing Address - Fax:212-410-6430
Practice Address - Street 1:899 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6103
Practice Address - Country:US
Practice Address - Phone:646-745-2888
Practice Address - Fax:212-410-6430
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-30
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY207109207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01959631Medicaid
G89221Medicare UPIN
PK048C5820Medicare ID - Type Unspecified