Provider Demographics
NPI:1194741421
Name:MILLER, SARAH L (PA)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1345 RXR PLZ FL 13
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11556-1301
Mailing Address - Country:US
Mailing Address - Phone:516-453-0435
Mailing Address - Fax:646-846-3283
Practice Address - Street 1:1930 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:NY
Practice Address - Zip Code:11729-3328
Practice Address - Country:US
Practice Address - Phone:631-254-5900
Practice Address - Fax:631-392-0948
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2019-12-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY009444363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ07611Medicare UPIN
NY52184Medicare PIN