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General NPI Number Information
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NPI Number | 1801528732
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Entity Type | Individual
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Provider Name | ILENE MILLER LM, CNM, MSN
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Gender | Female
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Dates
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Enumeration Date | 06/29/2022
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Last Update Date | 06/29/2022
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Provider Practice Location Address
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Address Line | THE GUIRGUIS OBSTETRICS & GYNECOLOGY GROUP 522 THIRD ST
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City | BROOKLYN
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State | NY
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Zip | 11215
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Country | US
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Telephone | 718-768-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 191 MADISON ST # 2
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City | BROOKLYN
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State | NY
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Zip | 11216-1603
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Country | US
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Telephone | 917-816-4498
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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 | 163WP1700X
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Taxonomy Name | Perinatal Registered Nurse
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License Number | 678833
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 002154
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License Number State | NY
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