Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 38MC00559700 | NJ |
NPI | 1770846610 |
---|---|
Provider Name | Dr. Melinda Lee Miller |
First Address | Pompton Lakes, NJ 07442-2062 |
Second Address | Pompton Lakes, NJ 07442-2062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2012 |
Last Update Date | 15/06/2012 |