MEDICARE: GREGG MILLER NEW YORK CITY MEDICAL SERVICES PLLC

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	207RN0300X	Nephrology Physician	262874	NY

General Provider Information

NPI Number	:	1942656681
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREGG MILLER NEW YORK CITY MEDICAL SERVICES PLLC

Provider Business Mailing Address
First Line	:	1776 EASTCHESTER RD
Second Line	:	SUITE 240
City	:	BRONX
State	:	NY
Zip	:	10461-2341
Country	:	US
Telephone Number	:	480-639-7185
Fax Number	:	602-798-8267

Provider Business Practice Location Address
First Line	:	1776 EASTCHESTER RD
Second Line	:	SUITE 240
City	:	BRONX
State	:	NY
Zip	:	10461-2341
Country	:	US
Telephone Number	:	480-636-9718
Fax Number	:	602-798-8267

Authorized Official
Title or Position	:	CORPORATE VP
Name	:	CARYL SCHARPF
Credential	:
Telephone Number	:	480-639-7185

Provider Enumeration Date	:	05/12/2016
Last Update Date	:	05/12/2016

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