James Charles Komar, | |
560 W 168th St, New York, NY 10032-3917 | |
(443) 604-2423 | |
Not Available |
Full Name | James Charles Komar |
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Gender | Male |
Speciality | Nurse Anesthetist, Certified Registered |
Location | 560 W 168th St, New York, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1922626746 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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367500000X | Nurse Anesthetist, Certified Registered | 26NJ01387500 (New Jersey) | Primary |
163WC0200X | Registered Nurse - Critical Care Medicine | 716144 (New York) | Secondary |
Entity Name | Rwjbh Observation Associates Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760095806 PECOS PAC ID: 5193137503 Enrollment ID: O20201209000008 |
Mailing Address | Practice Location Address |
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James Charles Komar, 128 Fort Washington Ave Apt 7b, New York, NY 10032-4737 Ph: (973) 851-9910 | James Charles Komar, 560 W 168th St, New York, NY 10032-3917 Ph: (443) 604-2423 |
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