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General NPI Number Information
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NPI Number | 1407451925
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Entity Type | Individual
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Provider Name | VANESSA KOMAREK PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 12/02/2020
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 625 PANORAMA TRL STE 1120
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City | ROCHESTER
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State | NY
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Zip | 14625-2432
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Country | US
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Telephone | 585-557-2389
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Fax | 585-310-7165
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Provider Business Mailing Address
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Address Line | 2324 FAIRPORT NINE MILE PT RD
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City | FAIRPORT
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State | NY
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Zip | 14450-8504
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Country | US
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Telephone | 585-557-2389
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Fax | 585-282-0091
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | P107862
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 024800
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License Number State | NY
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