Individual
KRISTINE ANNE KOMADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
BETHANY HOUSE II, 199-19 113TH AVENUE, ST ALBANS, NY 11412
(917) 685-7145
Mailing address
4809 216TH ST, BAYSIDE HILLS, NY 11364-1334
(347) 453-6171
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
9182
NY
Other
Enumeration date
06/09/2021
Last updated
06/09/2021
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