Healthcare Provider Details

I. General information

NPI: 1306813720
Provider Name (Legal Business Name): ALAN RICHARD MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 CLOSTER DOCK ROAD
CLOSTER NJ
07624-1947
US

IV. Provider business mailing address

235 CLOSTER DOCK ROAD
CLOSTER NJ
07624-1947
US

V. Phone/Fax

Practice location:
  • Phone: 201-666-0013
  • Fax: 877-547-5841
Mailing address:
  • Phone: 201-666-0013
  • Fax: 877-547-5841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number25MA05269300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: