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General NPI Number Information
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NPI Number | 1053019299
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Entity Type | Organization
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Legal Business Name | DR. MILLER PEDIATRICS
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Dates
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Enumeration Date | 02/17/2023
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Last Update Date | 02/17/2023
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Provider Practice Location Address
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Address Line | 21 JAMES P KELLY WAY
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City | MIDDLETOWN
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State | NY
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Zip | 10940-9465
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Country | US
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Telephone | 845-645-2719
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Fax |
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Provider Business Mailing Address
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Address Line | 21 JAMES P KELLY WAY
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City | MIDDLETOWN
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State | NY
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Zip | 10940-9465
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Country | US
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Telephone | 845-645-2719
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Fax |
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Authorized Official
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Title or Position | MD
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Name | MICHAEL MILLER
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Credential |
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Telephone | 845-645-2719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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