Individual
JULIA ANNE MANDSAGER KOMATSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2207 BOSTON ROAD, WILBRAHAM, MA 01095
(413) 599-1201
(413) 596-2940
Mailing address
2207 BOSTON ROAD, WILBRAHAM, MA 01095
(413) 599-1201
(413) 596-2940
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
1015865
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110201385A
—
MA
Enumeration date
04/05/2020
Last updated
11/20/2023
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