MEDICARE: MR. THOMAS E MILLER LCSW

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
1	101Y00000X	Counselor	056166-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336206200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS E MILLER LCSW

Provider Business Mailing Address
First Line	:	53 S RIDGE RD
Second Line	:
City	:	POMONA
State	:	NY
Zip	:	10970-2105
Country	:	US
Telephone Number	:	845-309-0900
Fax Number	:	845-680-0211

Provider Business Practice Location Address
First Line	:	53 S RIDGE RD
Second Line	:
City	:	POMONA
State	:	NY
Zip	:	10970-2105
Country	:	US
Telephone Number	:	845-309-0900
Fax Number	:	845-680-0211

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	07/09/2007

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