Individual
DR. KEVIN DOUGLAS KOMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
900 CENTER ST, LEWISTON, NY 14092-1737
(716) 754-2555
(716) 754-8650
Mailing address
222 SUNDOWN TRL, WILLIAMSVILLE, NY 14221-2202
(716) 689-9534
(716) 689-9534
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
VUT004540
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000102319-01
UNIVERA
NY
01
—
003900255
COMMUNITY BLUE
NY
01
—
32212
COLE MANAGED CARE
NY
01
—
7209530
INDEPENTENT HEALTH
NY
01
—
NY4540
EYEMED
NY
Enumeration date
07/07/2005
Last updated
02/28/2012
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