Individual
MARIA KOMISSAROVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 SPINDRIFT DR, WILLIAMSVILLE, NY 14221-7800
(716) 631-2500
Mailing address
55 SPINDRIFT DR, WILLIAMSVILLE, NY 14221-7800
(716) 631-2500
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301092650
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/07/2008
Last updated
04/20/2020
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