Provider Demographics
NPI:1609801927
Name:KOMORNICKI, ISABEL K (NP)
Entity Type:Individual
Prefix:MS
First Name:ISABEL
Middle Name:K
Last Name:KOMORNICKI
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8000 DEPT 313
Mailing Address - Street 2:UNIVERSITY AT BUFFALO SURGEONS, INC.
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14267-0002
Mailing Address - Country:US
Mailing Address - Phone:716-898-5227
Mailing Address - Fax:716-898-5029
Practice Address - Street 1:100 HIGH ST
Practice Address - Street 2:DEPT. OF SURGERY
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1126
Practice Address - Country:US
Practice Address - Phone:716-887-4221
Practice Address - Fax:716-887-4220
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2012-04-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NYF302337363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02504745Medicaid
RB4653OtherMEDICARE
P95898Medicare UPIN