MEDICARE: DR. CHRISTOPHER MILLS O.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	152W00000X	Optometrist	007932	NY

General Provider Information

NPI Number	:	1790039204
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER MILLS O.D.

Provider Business Mailing Address
First Line	:	207 E 37TH ST
Second Line	:	APT 3G
City	:	NEW YORK
State	:	NY
Zip	:	10016-3160
Country	:	US
Telephone Number	:	704-264-7593
Fax Number	:

Provider Business Practice Location Address
First Line	:	207 E 37TH ST
Second Line	:	APT 3G
City	:	NEW YORK
State	:	NY
Zip	:	10016-3160
Country	:	US
Telephone Number	:	704-264-7593
Fax Number	:

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

Provider Enumeration Date	:	11/06/2012
Last Update Date	:	11/06/2012

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