Healthcare Provider Details

I. General information

NPI: 1639351752
Provider Name (Legal Business Name): DR NEIL P MILLER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 11/30/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 CHURCH ST
SARANAC LAKE NY
12983-1860
US

IV. Provider business mailing address

88 CHURCH ST
SARANAC LAKE NY
12983-1860
US

V. Phone/Fax

Practice location:
  • Phone: 518-891-0680
  • Fax: 518-891-0683
Mailing address:
  • Phone: 518-891-0680
  • Fax: 518-891-0683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberTUV0032761
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License NumberTUV0032761
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License NumberTUV0032761
License Number StateNY

VIII. Authorized Official

Name: DR. NEIL P MILLER
Title or Position: OWNER
Credential: OD
Phone: 518-891-0680