Provider Demographics
NPI:1104186055
Name:KOMENDYAK, IRYNA (NP)
Entity type:Individual
Prefix:
First Name:IRYNA
Middle Name:
Last Name:KOMENDYAK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2455 HARING ST APT 1H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1821
Mailing Address - Country:US
Mailing Address - Phone:917-741-0550
Mailing Address - Fax:
Practice Address - Street 1:3000 OCEAN PKWY STE L1
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8344
Practice Address - Country:US
Practice Address - Phone:929-703-2772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-25
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY635483-1163W00000X
NY347498364SF0001X
NYF347498-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health