Provider Demographics
NPI:1962577221
Name:MILLER, COLUMBIA (DC)
Entity type:Individual
Prefix:DR
First Name:COLUMBIA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-3673
Mailing Address - Country:US
Mailing Address - Phone:845-781-7813
Mailing Address - Fax:845-781-8125
Practice Address - Street 1:154 SPRING ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-3673
Practice Address - Country:US
Practice Address - Phone:845-781-7813
Practice Address - Fax:845-781-8125
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX-005905111N00000X, 111NN1001X, 111NR0400X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP776831OtherOXFORD
NYP776831OtherOXFORD