=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700968070
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HALEH MILANI MD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/19/2006
-----------------------------------------------------
Last Update Date | 07/06/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 115 CENTRAL PARK WEST SUITE 1
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10023
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-543-3400
-----------------------------------------------------
Fax | 212-873-1960
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 RIVERSIDE BLVD #15D
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10069
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-543-3400
-----------------------------------------------------
Fax | 212-873-1960
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 196482
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------