Provider Demographics
NPI:1073816526
Name:MILLER, EILEEN (RN-ANP)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN-ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5852 212TH ST
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11364-1822
Mailing Address - Country:US
Mailing Address - Phone:718-279-3306
Mailing Address - Fax:718-279-3306
Practice Address - Street 1:6110 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-5776
Practice Address - Country:US
Practice Address - Phone:718-397-2002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY278145163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health