Healthcare Provider Details

I. General information

NPI: 1588811806
Provider Name (Legal Business Name): LEAH COHEN MILLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LONGWOOD AVE DEVELOPMENTAL MEDICINE CENTER, FEGAN 10
BOSTON MA
02115-5724
US

IV. Provider business mailing address

300 LONGWOOD AVENUE DEVELOPMENTAL MEDICINE CENTER, MAILSTOP 3217
BOSTON MA
02115
US

V. Phone/Fax

Practice location:
  • Phone: 781-355-7025
  • Fax: 617-730-0252
Mailing address:
  • Phone: 781-355-7025
  • Fax: 617-730-0252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number274512
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: