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General NPI Number Information
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NPI Number | 1194729780
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Entity Type | Individual
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Provider Name | MARTIN G MILLER D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 03/28/2008
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Provider Practice Location Address
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Address Line | 23 ATLANTIC AVE
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City | FREEPORT
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State | NY
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Zip | 11520-5103
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Country | US
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Telephone | 516-867-0560
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Fax | 516-867-0561
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Provider Business Mailing Address
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Address Line | 88 HARMON ST
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City | LONG BEACH
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State | NY
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Zip | 11561-2712
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Country | US
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Telephone | 516-889-7056
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Fax |
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N003272
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License Number State | NY
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