Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 058184 | NY |
N | 213EG0000X | General Practice | 058184 | NY |
Y | 1223G0001X | General Practice | 22DI02620100 | NJ |
Y | 213EG0000X | General Practice | 22DI02620100 | NJ |
NPI | 1003212028 |
---|---|
Provider Name | Dr. Christopher Miller |
First Address | Jersey City, NJ 07302-5404 |
Second Address | Bridgewater, NJ 08807-2153 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2014 |
Last Update Date | 28/12/2015 |