Healthcare Provider Details

I. General information

NPI: 1831419001
Provider Name (Legal Business Name): SUZANNE MARIE MILLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 03/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

652 DELAWARE AVE SUITE 204
BUFFALO NY
14202
US

IV. Provider business mailing address

580 PLEASANT VIEW DR
LANCASTER NY
14086-1404
US

V. Phone/Fax

Practice location:
  • Phone: 716-882-3151
  • Fax:
Mailing address:
  • Phone: 716-685-6730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberF401254-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: