Healthcare Provider Details

I. General information

NPI: 1316628670
Provider Name (Legal Business Name): C. MILLER FAMILY HEALTH NP PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2023
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

936 E GUN HILL RD
BRONX NY
10469-3708
US

IV. Provider business mailing address

936 E GUN HILL RD
BRONX NY
10469-3708
US

V. Phone/Fax

Practice location:
  • Phone: 718-957-7544
  • Fax: 718-957-7545
Mailing address:
  • Phone: 718-957-7544
  • Fax: 718-957-7545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CAVEL MILLER
Title or Position: CEO
Credential: FNP
Phone: 718-957-7544