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NPI Code Detail

MEDICARE: MRS. AMY QUINN MILLER RD, CDE, CDN

MEDICARE: MRS. AMY QUINN MILLER RD, CDE, CDN
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
1133V00000XRegistered Dietitian005712NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000527554001OTHERNYBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1982897179
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY QUINN MILLER RD, CDE, CDN
Provider Business Mailing Address
First Line : 127 NORTH ST
Second Line :
City : BATAVIA
State : NY
Zip : 14020-1631
Country : US
Telephone Number : 585-343-6030
Fax Number : 585-344-5267
Provider Business Practice Location Address
First Line : 211 E MAIN ST
Second Line :
City : BATAVIA
State : NY
Zip : 14020-2231
Country : US
Telephone Number : 585-344-5391
Fax Number : 585-344-5267
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2007
Last Update Date : 02/09/2012

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