Provider Demographics
NPI:1982871638
Name:KOMESHOK, ADRIANNA (APN-ADULT NP)
Entity Type:Individual
Prefix:MRS
First Name:ADRIANNA
Middle Name:
Last Name:KOMESHOK
Suffix:
Gender:F
Credentials:APN-ADULT NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MUNSON DR
Mailing Address - Street 2:POMPTON PLAINS
Mailing Address - City:POMPTON PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07444-1507
Mailing Address - Country:US
Mailing Address - Phone:908-256-3903
Mailing Address - Fax:
Practice Address - Street 1:186 ROCHELLE AVE
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-4122
Practice Address - Country:US
Practice Address - Phone:551-996-9230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00158900363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health