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NPI Code Detail

MEDICARE: ELISHEVA B MILLER PHYSICIAN ASSISTANT

MEDICARE:   ELISHEVA B MILLER  PHYSICIAN ASSISTANT
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
1363A00000XPhysician Assistant011247NY

General Provider Information

NPI Number : 1669409348
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISHEVA B MILLER PHYSICIAN ASSISTANT
Provider Business Mailing Address
First Line : 813 QUENTIN RD
Second Line :
City : BROOKLYN
State : NY
Zip : 11223-2251
Country : US
Telephone Number : 718-998-8291
Fax Number : 718-375-5212
Provider Business Practice Location Address
First Line : 813 QUENTIN RD
Second Line :
City : BROOKLYN
State : NY
Zip : 11223-2251
Country : US
Telephone Number : 718-998-8291
Fax Number : 718-375-5212
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2006
Last Update Date : 01/31/2011

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Directions to “ ELISHEVA B MILLER PHYSICIAN ASSISTANT” Practice Location

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