MEDICARE: DR. GREGORY PAUL MILLER M.D

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	2084P0800X	Psychiatry Physician	170185-01	NY

General Provider Information

NPI Number	:	1558379941
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY PAUL MILLER M.D

Provider Business Mailing Address
First Line	:	2 TOWER PL
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12203-3735
Country	:	US
Telephone Number	:	518-446-9979
Fax Number	:	518-446-9979

Provider Business Practice Location Address
First Line	:	2 TOWER PL
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12203-3735
Country	:	US
Telephone Number	:	518-446-9979
Fax Number	:	518-446-9979

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	03/23/2021

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