MEDICARE: WESTCHESTER BRONX OB GYN GROUP PC

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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1376707455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTCHESTER BRONX OB GYN GROUP PC

Provider Business Mailing Address
First Line	:	1250 WATERS PLACE
Second Line	:	SUITE 1206
City	:	BRONX
State	:	NY
Zip	:	10461-1001
Country	:	US
Telephone Number	:	718-409-5454
Fax Number	:	718-409-0857

Provider Business Practice Location Address
First Line	:	1250 WATERS PL
Second Line	:	SUITE 1206
City	:	BRONX
State	:	NY
Zip	:	10461-2720
Country	:	US
Telephone Number	:	718-409-5454
Fax Number	:	718-409-0857

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DANIEL R MILLER
Credential	:	MD
Telephone Number	:	718-409-5454

Provider Enumeration Date	:	07/17/2008
Last Update Date	:	01/20/2015

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Practice Location Address:

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