MEDICARE: KATHRYN MILLER

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	225X00000X	Occupational Therapist	030792	NY

General Provider Information

NPI Number	:	1518825348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN MILLER

Provider Business Mailing Address
First Line	:	26 NORBROOK RD
Second Line	:
City	:	FAIRPORT
State	:	NY
Zip	:	14450-8958
Country	:	US
Telephone Number	:	585-271-0680
Fax Number	:

Provider Business Practice Location Address
First Line	:	1000 ELMWOOD AVE STE 400
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14620-3092
Country	:	US
Telephone Number	:	585-271-0680
Fax Number	:

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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