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General NPI Number Information
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NPI Number | 1013089044
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Entity Type | Individual
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Provider Name | KEVIN JOHN MILLER PHD
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Gender | Male
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 135 COLUMBIA TPKE 101
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City | FLORHAM PARK
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State | NJ
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Zip | 07932-2104
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Country | US
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Telephone | 973-560-0595
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Fax | 973-560-0490
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Provider Business Mailing Address
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Address Line | 33 PARKSIDE DR
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City | EAST HANOVER
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State | NJ
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Zip | 07936-1714
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Country | US
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Telephone | 973-560-0595
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Fax | 973-560-0490
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3630
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License Number State | NJ
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