Healthcare Provider Details

I. General information

NPI: 1437061363
Provider Name (Legal Business Name): MELISSA J MILLER OT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W PUTNAM AVE
GREENWICH CT
06830-6086
US

IV. Provider business mailing address

4 ROCK RIDGE DR
RYE BROOK NY
10573-1214
US

V. Phone/Fax

Practice location:
  • Phone: 203-863-3000
  • Fax: 203-863-4590
Mailing address:
  • Phone: 203-860-3000
  • Fax: 203-263-4590

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number003693
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: