Provider Demographics
NPI:1750568457
Name:KOMAROW, MICHAEL STEVEN (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STEVEN
Last Name:KOMAROW
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:28 APPALACHIAN W
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6711
Mailing Address - Country:US
Mailing Address - Phone:845-897-5115
Mailing Address - Fax:845-897-5115
Practice Address - Street 1:28 APPALACHIAN W
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-6711
Practice Address - Country:US
Practice Address - Phone:845-897-5115
Practice Address - Fax:845-897-5115
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-24
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1237272085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology