Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 243125-1 | NY |
NPI | 1003038530 |
---|---|
Provider Name | Lindsy Miller |
First Address | Mineola, NY 11501-3901 |
Second Address | Mineola, NY 11501-3957 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 08/07/2007 |