MEDICARE: MRS. JULIE MILLER RN

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	174H00000X	Health Educator	4558181	NY

General Provider Information

NPI Number	:	1710263546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JULIE MILLER RN

Provider Business Mailing Address
First Line	:	155 DELAWARE RD
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14217-2445
Country	:	US
Telephone Number	:	716-874-8403
Fax Number	:	716-874-8650

Provider Business Practice Location Address
First Line	:	155 DELAWARE RD
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14217-2445
Country	:	US
Telephone Number	:	716-874-8403
Fax Number	:	716-874-8650

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

Provider Enumeration Date	:	10/25/2011
Last Update Date	:	10/25/2011

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