Provider Demographics
NPI:1386619179
Name:MILLER, DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 MAIN ST
Mailing Address - Street 2:HUDSON RIVER HEALTHCARE, INC.
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2913
Mailing Address - Country:US
Mailing Address - Phone:914-734-8800
Mailing Address - Fax:914-734-8786
Practice Address - Street 1:503 S BROADWAY STE 210
Practice Address - Street 2:HUDSON RIVER HEALTHCARE, INC.
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-6202
Practice Address - Country:US
Practice Address - Phone:914-965-9771
Practice Address - Fax:914-965-4724
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY163487207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01052304Medicaid
NY01052304Medicaid
NY06E581Medicare ID - Type Unspecified
NYA400027520Medicare PIN