Healthcare Provider Details

I. General information

NPI: 1346933140
Provider Name (Legal Business Name): CATHERINE LILLIANNE MILLER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2023
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 MILLBURN AVE STE A4
MAPLEWOOD NJ
07040-3745
US

IV. Provider business mailing address

3601 LIBERTY AVE # 311
NORTH BERGEN NJ
07047-2335
US

V. Phone/Fax

Practice location:
  • Phone: 973-761-6111
  • Fax:
Mailing address:
  • Phone: 315-705-7755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MB13165800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: