Individual
DR. KEVIN DOUGLAS KOMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
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
Update your record
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