Healthcare Provider Details

I. General information

NPI: 1114551827
Provider Name (Legal Business Name): STEVEN NEAL MILLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2020
Last Update Date: 03/03/2020
Certification Date: 03/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 BLAIR DR
HUNTINGTON NY
11743-2465
US

IV. Provider business mailing address

29 BLAIR DR
HUNTINGTON NY
11743-2465
US

V. Phone/Fax

Practice location:
  • Phone: 631-424-2624
  • Fax:
Mailing address:
  • Phone: 631-424-2624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number141723
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: