Provider Demographics
NPI:1316975725
Name:MILLER, DINA KAYE (MD)
Entity type:Individual
Prefix:DR
First Name:DINA
Middle Name:KAYE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 ARRANDALE AVE
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11024-1803
Mailing Address - Country:US
Mailing Address - Phone:516-423-6239
Mailing Address - Fax:
Practice Address - Street 1:1752 FRANCIS LEWIS BLVD
Practice Address - Street 2:
Practice Address - City:WHITESTONE
Practice Address - State:NY
Practice Address - Zip Code:11357-3247
Practice Address - Country:US
Practice Address - Phone:718-746-9494
Practice Address - Fax:718-746-4963
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-28
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY171360208100000X, 2081P2900X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE66940Medicare UPIN
NY57045XMedicare PIN
NY57045Medicare PIN