Provider Demographics
NPI:1699114058
Name:MILLER, HOWARD J
Entity type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:J
Last Name:MILLER
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 1:680 HOPE ST
Mailing Address - Street 2:UNIT 10
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06907-2624
Mailing Address - Country:US
Mailing Address - Phone:203-856-6704
Mailing Address - Fax:
Practice Address - Street 1:680 HOPE ST
Practice Address - Street 2:UNIT 10
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06907-2624
Practice Address - Country:US
Practice Address - Phone:203-856-6704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist