Healthcare Provider Details

I. General information

NPI: 1316163025
Provider Name (Legal Business Name): ARIANA ROSE KOMAROFF NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ARIANA JANE ROSE NP

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HARRISON AVE STE G105-2
MAMARONECK NY
10543-3145
US

IV. Provider business mailing address

1600 HARRISON AVE STE G105-2
MAMARONECK NY
10543-3145
US

V. Phone/Fax

Practice location:
  • Phone: 914-412-6335
  • Fax: 914-357-2727
Mailing address:
  • Phone: 914-412-6335
  • Fax: 914-357-2727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number512951
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number006193
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number334364
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: