Provider Demographics
NPI:1063612596
Name:KNIGHT, COLETTE MONIQUE (MD)
Entity type:Individual
Prefix:
First Name:COLETTE
Middle Name:MONIQUE
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 OVERLOOK AVE
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2206
Mailing Address - Country:US
Mailing Address - Phone:201-489-5999
Mailing Address - Fax:201-489-1898
Practice Address - Street 1:150 OVERLOOK AVE
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2206
Practice Address - Country:US
Practice Address - Phone:201-489-5999
Practice Address - Fax:201-489-1898
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY228132207RE0101X
NJ25MA08204800207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism