MEDICARE: RONALD MILLMAN

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	152W00000X	Optometrist	27OA00279900	NJ

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	:	1508825852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD MILLMAN

Provider Business Mailing Address
First Line	:	16 N MORRIS ST
Second Line	:
City	:	DOVER
State	:	NJ
Zip	:	07801-3910
Country	:	US
Telephone Number	:	973-366-1571
Fax Number	:	973-366-1576

Provider Business Practice Location Address
First Line	:	16 N MORRIS ST
Second Line	:
City	:	DOVER
State	:	NJ
Zip	:	07801-3910
Country	:	US
Telephone Number	:	973-366-1571
Fax Number	:	973-366-1576

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	03/21/2014

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Directions to “ RONALD MILLMAN ” Practice Location

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