MEDICARE: CLARE ELIZABETH PARME MILLER RD, CDN

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	133V00000X	Registered Dietitian	011760-01	NY

General Provider Information

NPI Number	:	1194561795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLARE ELIZABETH PARME MILLER RD, CDN

Provider Business Mailing Address
First Line	:	500 8TH AVENUE FRNT 3
Second Line	:	#1546
City	:	NEW YORK
State	:	NY
Zip	:	10018
Country	:	US
Telephone Number	:	619-985-2486
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 8TH AVENUE FRNT 3
Second Line	:	#1546
City	:	NEW YORK
State	:	NY
Zip	:	10018
Country	:	US
Telephone Number	:	619-985-2486
Fax Number	:

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

Provider Enumeration Date	:	07/02/2024
Last Update Date	:	07/28/2025

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