Provider Demographics
NPI:1407071681
Name:MILLMAN, PERI NICOLE (MD)
Entity type:Individual
Prefix:DR
First Name:PERI
Middle Name:NICOLE
Last Name:MILLMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:530 W 236TH ST
Mailing Address - Street 2:#4G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1748
Mailing Address - Country:US
Mailing Address - Phone:718-884-1565
Mailing Address - Fax:718-884-1565
Practice Address - Street 1:3459 BROADWAY
Practice Address - Street 2:CH7N-702
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10031-5629
Practice Address - Country:US
Practice Address - Phone:212-305-7082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2325862080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology