Healthcare Provider Details

I. General information

NPI: 1902261530
Provider Name (Legal Business Name): HELENE MILLER, MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2015
Last Update Date: 07/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 ARCADIAN WAY SUITE 108
PARAMUS NJ
07652-1245
US

IV. Provider business mailing address

17 ARCADIAN WAY SUITE 108
PARAMUS NJ
07652-1245
US

V. Phone/Fax

Practice location:
  • Phone: 201-316-5581
  • Fax:
Mailing address:
  • Phone: 201-316-5581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMA07400600
License Number StateNJ

VIII. Authorized Official

Name: MR. MICHAEL EPSTEIN
Title or Position: COO
Credential: MBA
Phone: 201-316-5581