Healthcare Provider Details

I. General information

NPI: 1295953396
Provider Name (Legal Business Name): DOROTHY ANNE MILLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 MADISON AVE BOX 1240
NEW YORK NY
10029-6514
US

IV. Provider business mailing address

106 GAYLOR RD APT 2A
SCARSDALE NY
10583-5808
US

V. Phone/Fax

Practice location:
  • Phone: 212-659-9351
  • Fax: 212-348-5901
Mailing address:
  • Phone: 516-659-4216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number235922
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: