Provider Demographics
NPI:1528113503
Name:MILLER, ERIC B (PHD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:B
Last Name:MILLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-3424
Mailing Address - Country:US
Mailing Address - Phone:610-933-8145
Mailing Address - Fax:
Practice Address - Street 1:125 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-3424
Practice Address - Country:US
Practice Address - Phone:610-933-8145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC000874174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010993880001Medicare ID - Type UnspecifiedMUSIC THERAPY PROVIDER