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General NPI Number Information
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NPI Number | 1326121799
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Entity Type | Individual
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Provider Name | DAVID MARK MILLER PH.D.
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Gender | Male
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Dates
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Enumeration Date | 10/21/2006
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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 E 50TH ST SUITE 103
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City | NEW YORK
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State | NY
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Zip | 10022-7504
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Country | US
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Telephone | 212-319-5981
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Fax | 212-319-5981
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Provider Business Mailing Address
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Address Line | 201 E 79TH ST APT 3H
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City | NEW YORK
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State | NY
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Zip | 10021-0830
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Country | US
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Telephone | 212-535-3990
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Fax | 212-319-5981
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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 | 11845
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License Number State | NY
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