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General NPI Number Information
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NPI Number | 1003082009
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Entity Type | Organization
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Legal Business Name | DR LESLIE R MILLER PC
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Dates
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Enumeration Date | 04/30/2008
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Last Update Date | 07/14/2008
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Provider Practice Location Address
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Address Line | 52 BEACH RD
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City | FAIRFIELD
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State | CT
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Zip | 06824-6017
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Country | US
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Telephone | 203-256-9905
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Fax | 203-254-9848
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Provider Business Mailing Address
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Address Line | 52 BEACH RD
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City | FAIRFIELD
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State | CT
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Zip | 06824-6017
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Country | US
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Telephone | 203-256-9905
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Fax | 203-254-9848
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Authorized Official
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Title or Position | OWNER, MEDICAL PROVIDER
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Name | MRS. LESLIE ROBIN MILLER
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Credential | D.O
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Telephone | 203-256-9905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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