Provider Demographics
NPI:1487079810
Name:KOMPERDA, KAZIMIERZ WALTER (MD)
Entity type:Individual
Prefix:DR
First Name:KAZIMIERZ
Middle Name:WALTER
Last Name:KOMPERDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:KASEY
Other - Middle Name:
Other - Last Name:KOMPERDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:10 UNION SQ E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3314
Mailing Address - Country:US
Mailing Address - Phone:212-844-6700
Mailing Address - Fax:
Practice Address - Street 1:10 UNION SQ E STE 3K
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3314
Practice Address - Country:US
Practice Address - Phone:212-844-6750
Practice Address - Fax:212-844-6751
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-21
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY291432207XX0005X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine