Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 158155 | NY |
NPI | 1003856030 |
---|---|
Provider Name | Dr. Eileen Marie Miles |
First Address | New York, NY 10024-6004 |
Second Address | New York, NY 10002-7537 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A63634 | (02) | NY |