Provider Demographics
NPI: | 1902993074 |
---|---|
Name: | MILLER, DAVID H (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | DAVID |
Middle Name: | H |
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: | 520 E 70TH ST # STARR-4 |
Mailing Address - Street 2: | |
Mailing Address - City: | NEW YORK |
Mailing Address - State: | NY |
Mailing Address - Zip Code: | 10021-9800 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 212-746-0373 |
Mailing Address - Fax: | 212-746-7481 |
Practice Address - Street 1: | 520 E 70TH ST # STARR-4 |
Practice Address - Street 2: | |
Practice Address - City: | NEW YORK |
Practice Address - State: | NY |
Practice Address - Zip Code: | 10021-9800 |
Practice Address - Country: | US |
Practice Address - Phone: | 212-746-2150 |
Practice Address - Fax: | 212-746-6665 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-10-09 |
Last Update Date: | 2023-09-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
NY | 131148 | 207R00000X, 207RC0000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NY | 00791328 | Medicaid | |
NY | 46A141 | Medicare ID - Type Unspecified | |
NY | 00791328 | Medicaid |