MEDICARE: MRS. JANET M. F. MILLER RPA-C

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	363A00000X	Physician Assistant	004486-1	NY

General Provider Information

NPI Number	:	1578724290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JANET M. F. MILLER RPA-C

Provider Business Mailing Address
First Line	:	1013 W BEECH ST
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-1203
Country	:	US
Telephone Number	:	516-431-7600
Fax Number	:	516-431-7691

Provider Business Practice Location Address
First Line	:	1013 W BEECH ST
Second Line	:
City	:	LONG BEACH
State	:	NY
Zip	:	11561-1203
Country	:	US
Telephone Number	:	516-431-7600
Fax Number	:	516-431-7691

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

Provider Enumeration Date	:	06/25/2008
Last Update Date	:	04/30/2012

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