Provider Demographics
NPI:1124467642
Name:MILLER, RACHEL JOSEPHINE (NP)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:JOSEPHINE
Last Name:MILLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 GRAND STREET
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1035
Mailing Address - Country:US
Mailing Address - Phone:845-353-5600
Mailing Address - Fax:845-987-5979
Practice Address - Street 1:2 CROSFIELD AVENUE
Practice Address - Street 2:SUITE 318
Practice Address - City:WEST NYACK
Practice Address - State:NY
Practice Address - Zip Code:10994-0000
Practice Address - Country:US
Practice Address - Phone:845-353-5600
Practice Address - Fax:845-353-3474
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337915-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner