Provider Demographics
NPI:1497023840
Name:COMER, JANICE
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:COMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 W MILLER ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NY
Mailing Address - Zip Code:14513-1446
Mailing Address - Country:US
Mailing Address - Phone:315-332-3323
Mailing Address - Fax:315-332-3624
Practice Address - Street 1:316 W MILLER ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NY
Practice Address - Zip Code:14513-1446
Practice Address - Country:US
Practice Address - Phone:315-332-3323
Practice Address - Fax:315-332-3624
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10169529164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse