Healthcare Provider Details

I. General information

NPI: 1598904302
Provider Name (Legal Business Name): DAPHNE MILLER MEDICAL ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2009
Last Update Date: 02/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 HEMPSTEAD TURNPIKE ELMONT COMMUNITY HEALTH CENTER
ELMONT NY
11003
US

IV. Provider business mailing address

161 HEMPSTEAD TURNPIKE ELMONT COMMUNITY HEALTH CENTER
ELMONT NY
11003
US

V. Phone/Fax

Practice location:
  • Phone: 516-571-8200
  • Fax: 516-571-8221
Mailing address:
  • Phone: 516-571-8200
  • Fax: 516-571-8221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: