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General NPI Number Information
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NPI Number | 1467830810
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Entity Type | Individual
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Provider Name | SARAH LYON KOMLINE MD
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Gender | Female
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Dates
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Enumeration Date | 05/18/2015
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Last Update Date | 09/06/2024
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Provider Practice Location Address
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Address Line | 1 ROBERT WOOD JOHNSON PL
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1928
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Country | US
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Telephone | 732-828-3000
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Fax | 732-235-9340
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Provider Business Mailing Address
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Address Line | 111 E 18TH ST APT 405
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City | NORFOLK
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State | VA
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Zip | 23517-0018
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Country | US
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Telephone | 908-432-4695
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101264705
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | 25MA11561300
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License Number State | NJ
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