Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 1964471 | NY |
NPI | 1528002763 |
---|---|
Provider Name | Karl J Komar |
First Address | Watertown, NY 13601-4317 |
Second Address | Watertown, NY 13601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 13/08/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01582407 | (05) | NY |