Provider Demographics
NPI:1023664125
Name:KNOWLTON, EMILY (PA)
Entity type:Individual
Prefix:MISS
First Name:EMILY
Middle Name:
Last Name:KNOWLTON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 POST RD STE 202
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-5730
Mailing Address - Country:US
Mailing Address - Phone:203-254-9454
Mailing Address - Fax:203-254-0152
Practice Address - Street 1:2000 POST RD STE 202
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-5730
Practice Address - Country:US
Practice Address - Phone:203-254-9454
Practice Address - Fax:203-254-0152
Is Sole Proprietor?:No
Enumeration Date:2019-08-14
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4132363A00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine