Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 160104-1 | NY |
NPI | 1164507844 |
---|---|
Provider Name | Harvey J Miller |
First Address | Islip, NY 11751-3103 |
Second Address | Islip, NY 11751-3103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 06/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01105600 | (05) | NY |
D91830 | (02) | NY |