Provider Demographics
NPI:1962437889
Name:KOMOROSKI, GREGORY L (PT)
Entity type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:L
Last Name:KOMOROSKI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 ELM ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5448
Mailing Address - Country:US
Mailing Address - Phone:724-691-5362
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 307
Practice Address - Street 2:
Practice Address - City:NORVELT
Practice Address - State:PA
Practice Address - Zip Code:15674-0307
Practice Address - Country:US
Practice Address - Phone:724-424-4914
Practice Address - Fax:724-424-9822
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT005422L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist