MRS. LISA MARIE KOMNIK (NPI# 1881669505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881669505 |
| Entity Type | Individual |
| Full Name | MRS. LISA MARIE KOMNIK |
| Credential | MSC, ATC |
| Practice Address |
100 Nicholls Road Sports Complex G33 Stony Brook NY 11794-2325 |
| Mailing Address |
155 W Roe Blvd Danzi Athletic Center Patchogue NY 11772-2325 |
| Practice Telephone | 6316327164 |
| Practice Fax Number | 6316327210 |
| Mailing Telephone | 6314473330 |
| Mailing Fax Number | 6314473347 |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2020-09-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
000038-1 | NY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
100 NICHOLLS ROAD SPORTS COMPLEX G33 |
| City | STONY BROOK |
| State | NY |
| Zip Code | 11794-2325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619506714 | Ryan John Kottmeier | Physician Assistant | 101 Nicolls Road Suny Stony Brook Hospital, Dept of Orthopedics Hsc T18, Room 080, Stony Brook, NY 11794 | 2020-04-02 |
| 1699302109 | Michael Trentalange | Student in an Organized Health Care Education/Training Program | Department of Surgery, Health Sciences Center Level 19, Room 030, Stony Brook, NY 11794 | 2020-03-25 |
| 1164985156 | Lauren Kate Harris | Student in an Organized Health Care Education/Training Program | Stony Brook Medicine, Department of Ob/gyn, Hsc T9, 101 Nicolls Road, Stony Brook, NY 11794 | 2019-04-08 |
| 1851851448 | Kathy Tin | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc 16 Suny Stony Brook Hospital, Stony Brook, NY 11794 | 2019-03-21 |
| 1174083703 | Arham Khan | Student in an Organized Health Care Education/Training Program | Dept of Medicine Hsc Level 16, Suny Stony Brook Hosp, Stony Brook, NY 11794 | 2019-03-20 |
| 1396221982 | Aman Bhojani | Student in an Organized Health Care Education/Training Program | Suny At Stony Brook Dental School, South Drive, Stony Brook, NY 11794 | 2018-07-17 |
| 1699265629 | Belliny Phaeton | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Hospital, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-15 |
| 1629568969 | Rachel Herold | Student in an Organized Health Care Education/Training Program | Stony Brook Children's Department of Pediatrics, Hsc T-11, Room 040, Stony Brook, NY 11794 | 2018-05-11 |
| 1598254419 | Nora Ann Diraimondo | Nurse Practitioner | Sb Hospital 101 Nicolls Road, Department of Medicine, Stony Brook, NY 11794 | 2018-05-07 |
| 1386140705 | Ryan Christopher Corn | Student in an Organized Health Care Education/Training Program | Dept. of Internal Medicine, Hsc Level 16-020, Suny Stony Brook, Stony Brook, NY 11794 | 2018-04-04 |
| Find all providers in zip 11794 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831657147 | Nicholas Joseph Bufinsky II | Specialist/Technologist | 6 Smith Ln, Stony Brook, NY 11790-1819 | 2019-03-05 |
| 1578084414 | Barbara Jean Ercolino | Specialist/Technologist | 100 Nicolls Rd S, Stony Brook University Indoor Sports Complex, Stony Brook, NY 11794-3500 | 2017-06-30 |
| 1831623438 | Daniel Leonard | Specialist/Technologist | 100 Circle Rd, Indoor Sports Complex, Stony Brook, NY 11794-3500 | 2017-04-20 |
| 1023460516 | Stephanie Shay | Specialist/Technologist | 4 Haskell Ln, Stony Brook, NY 11790-2311 | 2016-07-07 |
| 1346519774 | Andrew Martin Stull | Specialist/Technologist | Indoor Sports Complex 100 Nicolls Rd, Stony Brook, NY 11794-0001 | 2011-12-13 |
| 1508948860 | Arturo R Flores Jr. | Specialist/Technologist | Indoor Sports Complex, Stony Brook University, Stony Brook, NY 11794-3500 | 2006-10-19 |
| 1871554519 | Kathryn Ann Koshansky | Specialist/Technologist | Stony Brook University, 100 Nicolls Rd, Stony Brook, NY 11794-3500 | 2006-03-31 |
| 1528526027 | Guillermo Steven Escobar | Specialist/Technologist | 100 Nicolls Rd, Stony Brook, NY 11794-0001 | 2019-03-04 |
| 1902363724 | Schuyler Withington | Specialist/Technologist | 100 Nicolls Rd, Stony Brook, NY 11794-0001 | 2019-02-28 |
| 1144787904 | Murat Tabaru | Specialist/Technologist | 100 Nicolls Rd, Stony Brook, NY 11794-0001 | 2019-02-27 |
| Find all providers in STONY BROOK | ||||
| City | STONY BROOK |
| Zip Code | 11794 |
Please comment or provide details below to improve the information on MRS. LISA MARIE KOMNIK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.