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NPI Code Detail

MEDICARE: DR. TERESA R MILLER MD

MEDICARE:  DR. TERESA R MILLER  MD
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
12084P0800XPsychiatry Physician142564NY

General Provider Information

NPI Number : 1184798571
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERESA R MILLER MD
Provider Business Mailing Address
First Line : 4403 FIRE LANE 4
Second Line :
City : UNION SPRINGS
State : NY
Zip : 13160-3117
Country : US
Telephone Number : 315-889-1616
Fax Number :
Provider Business Practice Location Address
First Line : 4403 FIRE LANE 4
Second Line :
City : UNION SPRINGS
State : NY
Zip : 13160-3117
Country : US
Telephone Number : 315-889-1616
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2006
Last Update Date : 01/15/2022

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Directions to “ DR. TERESA R MILLER MD” Practice Location

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