MEDICARE: DR. LENORE MILLIAN PH.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	103T00000X	Psychologist	01998	NJ

General Provider Information

NPI Number	:	1972616464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LENORE MILLIAN PH.D.

Provider Business Mailing Address
First Line	:	7 FLINT RIDGE RD
Second Line	:
City	:	DANBURY
State	:	CT
Zip	:	06811-3116
Country	:	US
Telephone Number	:	203-792-7006
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 TICE BLVD
Second Line	:
City	:	WOODCLIFF LAKE
State	:	NJ
Zip	:	07677-8410
Country	:	US
Telephone Number	:	201-934-7788
Fax Number	:

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

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	07/08/2007

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