Provider Demographics
NPI:1366318743
Name:WALDMILLER, PAUL
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:WALDMILLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31
Mailing Address - Street 2:
Mailing Address - City:ATTICA
Mailing Address - State:NY
Mailing Address - Zip Code:14011-0031
Mailing Address - Country:US
Mailing Address - Phone:813-580-3058
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 31
Practice Address - Street 2:
Practice Address - City:ATTICA
Practice Address - State:NY
Practice Address - Zip Code:14011-0031
Practice Address - Country:US
Practice Address - Phone:813-580-3058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLPC0510011021101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral