Provider Demographics
NPI:1912195231
Name:MILLIANO, ANTHONY JOSEPH SR (AUD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:MILLIANO
Suffix:SR
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4570 PECAN DR STE A
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-6717
Mailing Address - Country:US
Mailing Address - Phone:270-554-6000
Mailing Address - Fax:270-554-6995
Practice Address - Street 1:4570 PECAN DR STE A
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-6717
Practice Address - Country:US
Practice Address - Phone:270-554-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY0632237700000X
KYKY0245237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
655374OtherHEALTHLINK
KY000000326458OtherANTHEM
KY70002456Medicaid
4408277OtherAETNA
4408277OtherAETNA
655374OtherHEALTHLINK