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NPI 1881294791

NPI 1881294791 : SARAH J MILLER PSYD : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1881294791
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    Entity Type          |    Individual 
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    Provider Name        |    SARAH J MILLER PSYD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/29/2020
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    Last Update Date     |    10/29/2020
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Provider Practice Location Address
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    Address Line         |    1 GUSTAVE L LEVY PL 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10029-6504
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    Country              |    US
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    Telephone            |    630-234-7004
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    708 8TH AVE APT 3R 
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    City                 |    BROOKLYN
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    State                |    NY
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    Zip                  |    11215-6901
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    Country              |    US
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    Telephone            |    630-234-7004
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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        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    0979029
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    License Number State |    NY
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Taxonomy #2
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    Taxonomy Code        |    103TC0700X
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    Taxonomy Name        |    Clinical Psychologist
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    License Number       |    019740-01
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    License Number State |    NY
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