MEDICARE: JEREMY ADAM MILES MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	300073	NY
2	207RC0000X	Cardiovascular Disease Physician	25MA11682800	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114373917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMY ADAM MILES MD

Provider Business Mailing Address
First Line	:	777 TERRACE AVE STE 311
Second Line	:
City	:	HASBROUCK HEIGHTS
State	:	NJ
Zip	:	07604-3112
Country	:	US
Telephone Number	:	201-288-4252
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 TERRACE AVE STE 311
Second Line	:
City	:	HASBROUCK HEIGHTS
State	:	NJ
Zip	:	07604-3112
Country	:	US
Telephone Number	:	201-288-4252
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2016
Last Update Date	:	12/29/2023

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