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NPI Code Detail

MEDICARE: KATHLEEN ANN MILLER MS, RD, CDN

MEDICARE: KATHLEEN ANN MILLER MS, RD, CDN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian932856NY

General Provider Information

NPI Number : 1013914043
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN ANN MILLER MS, RD, CDN
Provider Business Mailing Address
First Line : 706 SACHEM CIR
Second Line :
City : SLINGERLANDS
State : NY
Zip : 12159-9545
Country : US
Telephone Number : 518-527-9186
Fax Number :
Provider Business Practice Location Address
First Line : 427 GUY PARK AVE
Second Line :
City : AMSTERDAM
State : NY
Zip : 12010-1054
Country : US
Telephone Number : 518-841-7186
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2005
Last Update Date : 08/02/2010

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