Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 031168 | CT |
NPI | 1578534640 |
---|---|
Provider Name | Jeffrey S Miller |
First Address | Litchfield, CT 06759-4107 |
Second Address | Torrington, CT 06790-6669 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 02/08/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001311688 | (05) | CT |
E10125 | (02) |