Healthcare Provider Details

I. General information

NPI: 1659370260
Provider Name (Legal Business Name): RANFORD V. MILLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2005
Last Update Date: 03/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 GUY PARK AVE SUITE 202
AMSTERDAM NY
12010-1043
US

IV. Provider business mailing address

2546 BALLTOWN RD SUITE 300
SCHENECTADY NY
12309-1079
US

V. Phone/Fax

Practice location:
  • Phone: 518-842-7088
  • Fax: 518-843-1324
Mailing address:
  • Phone: 518-377-8184
  • Fax: 518-377-0620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number179010
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number179010
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: