MEDICARE: ELAINE N MILLER 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	OEG002357	PA
2	152WC0802X	Corneal and Contact Management Optometrist	OEG002357	PA

General Provider Information

NPI Number	:	1962716654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELAINE N MILLER O.D.

Provider Business Mailing Address
First Line	:	6013 BABCOCK BLVD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15237-2502
Country	:	US
Telephone Number	:	412-364-4090
Fax Number	:	412-364-7990

Provider Business Practice Location Address
First Line	:	6013 BABCOCK BLVD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15237-2502
Country	:	US
Telephone Number	:	412-364-4090
Fax Number	:	412-364-7990

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

Provider Enumeration Date	:	08/05/2010
Last Update Date	:	08/05/2010

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