Healthcare Provider Details

I. General information

NPI: 1518903541
Provider Name (Legal Business Name): CAROL A. MILLER N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 HIGH ST
BUFFALO NY
14203-1149
US

IV. Provider business mailing address

6255 SHERIDAN DR
WILLIAMSVILLE NY
14221-4836
US

V. Phone/Fax

Practice location:
  • Phone: 716-630-1000
  • Fax: 716-630-1254
Mailing address:
  • Phone: 716-857-8666
  • Fax: 716-857-8944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF302556
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: