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General NPI Number Information
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NPI Number | 1104186055
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Entity Type | Individual
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Provider Name | IRYNA KOMENDYAK NP
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Gender | Female
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Dates
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Enumeration Date | 05/25/2012
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 3000 OCEAN PKWY STE L1
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City | BROOKLYN
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State | NY
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Zip | 11235-8344
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Country | US
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Telephone | 929-703-2772
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Fax |
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Provider Business Mailing Address
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Address Line | 2455 HARING ST APT 1H
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City | BROOKLYN
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State | NY
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Zip | 11235-1821
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Country | US
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Telephone | 917-741-0550
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 635483-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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License Number | 347498
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F347498-01
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License Number State | NY
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