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General NPI Number Information
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NPI Number | 1942472584
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Entity Type | Organization
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Legal Business Name | SHELDON W. MILLER DPM PC
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Dates
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Enumeration Date | 03/24/2008
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Last Update Date | 04/07/2009
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Provider Practice Location Address
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Address Line | 15 BEACH 105TH ST
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City | ROCKAWAY PARK
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State | NY
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Zip | 11694-2640
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Country | US
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Telephone | 718-474-0899
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Fax |
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Provider Business Mailing Address
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Address Line | 15 BEACH 105TH ST
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City | ROCKAWAY PARK
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State | NY
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Zip | 11694-2640
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Country | US
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Telephone | 718-474-0899
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHELDON MILLER
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Credential | D.P.M.
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Telephone | 718-474-0899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N004644
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License Number State | NY
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