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General NPI Number Information
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NPI Number | 1356785059
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Entity Type | Individual
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Provider Name | ADRIA LARA ROBERTI MILLER DO
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Gender | Female
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Dates
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Enumeration Date | 04/24/2013
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Last Update Date | 09/06/2018
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Provider Practice Location Address
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Address Line | 1815 S CLINTON AVE STE 310
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City | ROCHESTER
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State | NY
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Zip | 14618
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Country | US
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Telephone | 585-473-3535
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Fax |
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Provider Business Mailing Address
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Address Line | 23050 WEST RD SUITE 110
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City | BROWNSTOWN TWP
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State | MI
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Zip | 48183-1472
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Country | US
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Telephone | 585-737-8369
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 293517-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 5315075719
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License Number State | MI
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