MEDICARE: ARNE KOMAR LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225500000X	Respiratory/Developmental/Rehabilitative Specialist/Technologist	R031943-1	NY

General Provider Information

NPI Number	:	1871984922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARNE KOMAR LCSW

Provider Business Mailing Address
First Line	:	5392 SPRINGVIEW DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NY
Zip	:	13066-9678
Country	:	US
Telephone Number	:	315-637-2561
Fax Number	:

Provider Business Practice Location Address
First Line	:	5392 SPRINGVIEW DR
Second Line	:
City	:	FAYETTEVILLE
State	:	NY
Zip	:	13066-9678
Country	:	US
Telephone Number	:	315-637-2561
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2015
Last Update Date	:	02/11/2015

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